阴道内支架置入技术在治疗阴道后壁膨出伴直肠出口梗阻型排便困难中临床效果评价  

Clinical evaluation of vaginal stent technology in the treatment of outlet obstruction constipation associated with postierior vaginal wall prolapse

作　　者：尹一童[1] 夏志军[1] 宋悦[1] 胡清[1] 

机构地区：[1]中国医科大学附属盛京医院妇产科,沈阳110004

出　　处：《现代妇产科进展》2016年第9期673-675,共3页Progress in Obstetrics and Gynecology

摘　　要：目的:研究阴道内支架置入技术在治疗阴道后壁膨出伴直肠出口梗阻型排便困难中的临床价值。方法:对2010年10月至2015年6月我院收治的阴道后壁膨出伴直肠出口梗阻性排便困难的41例患者采用阴道内支架置入技术进行治疗。比较患者接受治疗前后的主观症状变化、评估出口梗阻便秘的Longo's评分变化,以及治疗前后直肠压力测定指标的变化情况。结果:41例患者的平均年龄(68.51±8.63)岁,孕次(3.70±0.98)次,产次(2.43±1.07)次。阴道后壁的POP-Q评分:Ba为(0.43±1.33)分,Bp为(1.14±1.57)分。治疗前后主观症状比较,自觉排便不尽感人数由22例降至11例,手指辅助排便人数由16例降至8例,差异有统计学意义(P<0.05),排便时间过长、排便费力出血及排便姿势怪异症状治疗前后无明显差异。与治疗前比较,治疗后Longo's评分总分降低,差异有统计学意义[(7.95±3.23)分vs(10.85±3.45)分,P<0.05];各分项评分中应力强度评分、应力时间评分、排便不尽感评分、灌肠辅助排便评分、手指辅助排便评分均显著下降(P均<0.05),其它各项指标未见明显差异。直肠静息压力由治疗前的(3.57±0.97)mm Hg升至(3.82±0.92)mm Hg,直肠力排压力由治疗前的(27.48±8.02)mm Hg升至(29.87±7.34)mm Hg,差异有统计学意义;治疗前后肛门静息压力及肛门力排压力未见明显变化。结论:阴道内支架置入技术治疗阴道后壁膨出伴出口梗阻型排便困难安全有效。Objective：To evaluate vaginal stent technology in the treatment of outlet obstruction constipation associated with postierior vaginal wall prolapse. Method：41 patients suffering from vaginal wall prolapse with outlet obstructive constipation from Oct. 2010 to June 2015 were selected. Vaginal stent technology was used in treatment. Compare the symptoms,the Longo＇s score and the rectal pressure measurement before and after treatment. Result：The aver-age age of patient was 68. 51 ±8. 63,pregnancies 3. 70 ±0. 98 times,parity 2. 43 ±1. 07 times. POP-Q：Ba：0. 43 ±1. 33,Bp：1. 14 ±1. 57. Through treatment,Patients who has poor stool de-crease from 22 to 11,while finger assisted defecation decrease from 16 to 8. While the symptoms of hard defecation,bleeding and odd posture while defecation didn＇t seem any significant differ-ence. Longo＇s mark decrease from 10. 85±3. 45 to 7. 95±3. 23. Rectal resting pressure increase from （3. 57±0. 97）mmHg to （3. 82±0. 92）mmHg,and rectal discharge pressure increase from （27. 48±8. 02）mmHg to （29. 87±7. 34）mmHg. Conclusion：Vaginal stent technology is a safe and effective way in the treatment of outlet obstructive constipation with vaginal wall prolapse.

关 键 词：直肠出口梗阻 阴道后壁膨出 阴道内支架 

分 类 号：R711[医药卫生—妇产科学]