改良 STARR 术治疗中重度直肠前突的疗效观察  

Clinical research of improved STARR in the treatment of moderate and severe rectocele

作　　者：项雄华 卿艳平[1] 刘丽丽[1] 吴为民[1] 金海波[1] 蔡张愉[1] 

机构地区：[1]宁波大学医学院附属医院肛肠外科,浙江省宁波315000

出　　处：《中国基层医药》2016年第16期2499-2504,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨改良 STARR 术治疗中重度直肠前突的临床疗效。方法选取中重度直肠前突患者70例，应用随机数字表法根据患者入院当日所在月份的奇偶随机分为对照组和观察组，对照组采用 Seha-payak 术治疗，观察组采用改良 STARR 术治疗。比较两组患者手术时间、术中出血量、术后疼痛评分、患者满意度、住院时间、复工时间等手术情况的差异；两组患者在术前、术后1周、1个月、3个月、6个月的 ODS 评分变化情况及临床疗效的差异；两组患者在术前、术后1个月及术后6个月行排粪造影，比较直肠前突改善情况。结果观察组患者的手术时间（29．76±8．40）min、术中出血量（14．43±8．16）mL、术后疼痛评分（4．29±1．76）分，均明显低于对照组手术时间（48．38±9．04）min、术中出血量（77．80±20．58）mL 及术后疼痛评分（4．29±1．76）分（t ＝8．934、16．935、5．338，均 P ＜0．05），观察组住院天数（6．71±1．22）d 及复工时间（7．20±1．36）d，均明显短于对照组[（11．23±3．64）d，（13．14±2．60）d（t ＝6．955、11．959，均 P ＜0．05），观察组患者对手术的满意度（8．83±0．98）分，高于对照组（7．54±1．20）分（t ＝4．908，P ＜0．05）。术后各随访时间点，两组患者的痊愈率、显效率及有效率的差异均无统计学意义（均 P ＞0．05）。观察组术前 ODS 评分为（20．97±4．38）分，术后1周为（4．71±1．30）分，术后1个月为（2．94±0．91）分，术后3个月为（1．68±1．04）分，术后6个月为（0．97±0．88）分；对照组术前为（19．88±4．09）分，术后依次为（4．65±1．28）分、（3．51±1．15）分、（2．88±1．67）分、（1．85±1．31）分，术后两组患者的 ODS 评分均较术前明显降低（t ＝20．666、23．904、26．127、26．401，均 P ＜0．05；t ＝22．882、24．081、24．032、25�Objective To study the therapeutic effect of improved STARR （Sehapayak as a control）in the treatment of moderate and severe rectocele.Methods 70 patients diagnosed with rectocele from Jan.2015 to Oct. 2015 were selected and randomly divided into 2 groups,35 cases in each group.They were treated with either improved STARR or Sehapayak surgery.The operation time,intraoperative blood loss,postoperative pain scores, patients＇satisfaction and hospitalization days were compared between 2 groups.The ODS scores and therapeutic effects were compared in 1st week,1st month,3rd month and 6th month after treatment.The defecography was implemented and compared between 2 groups before treatment and 1st week and 6th month after treatment.Results The operation time,intraoperative blood loss,postoperative pain scores,hospitalization days and time to return to work were signifi-cantly lower in STARR group than those in Sehapayak group[（29.76 ±8.40）min vs （48.38 ±9.04）min;（14.43 ± 8.16）mL vs （77.80 ±20.58）mL;（4.29 ±1.76）points vs （6.71 ±2.04）points;（6.71 ±1.22）d vs （11.23 ± 3.64）d;（7.20 ±1.36）d vs （13.14 ±2.60）d;t =8.934,16.935,5.338,6.955,11.959,all P 〈0.05],and the patients＇satisfaction was significantly higher in STARR group[（8.83 ±0.98）points vs （7.54 ±1.20）points,t =4.908,P 〈0.05].There were no significant differences in efficacy between 2 groups at any time point （P 〉0.05）. The ODS score was （20.97 ±4.38）points before treatment,（4.71 ±1.30）points 1week after treatment,（2.94 ± 0.91）points 1month later,（1.68 ±1.04）points 3months later and （0.97 ±0.88）points 6mons later in the observa-tion group.The ODS scores in the control group were （19.88 ±4.09）points,（4.65 ±1.28）points,（3.51 ±1.15） points,（2.88 ±1.67）points,（1.85 ±1.31）points,respectively.The postoperative ODS scores of the two groups of patients were compared with the preoperative decreased significantly （t =20.666,23.904,26.127,26.401,all P 〈0

关 键 词：直肠前突 排便梗阻综合征 改良STARR术 Sehapayak术 

分 类 号：R657.1[医药卫生—外科学]