痔上黏膜环形切除钉合术治疗直肠黏膜脱垂  

Clinical efficacy of procedure for prolapse and hemorrhoids for treatment of rectal mucosa prolapse

作　　者：任玲[1] 张光哲[1] 凌光烈[1] 

机构地区：[1]中国医科大学附属第一医院肛肠外科,辽宁沈阳110001

出　　处：《局解手术学杂志》2017年第1期29-32,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨痔上黏膜环形切除钉合术(PPH)治疗直肠黏膜脱垂的临床疗效。方法选择2013年6月至2015年6月于我科确诊患有直肠黏膜脱垂并首次行手术治疗的100例患者,根据手术方式的不同分为观察组和对照组,每组50例,观察组采用痔上黏膜环形切除钉合术,对照组采用传统黏膜折叠术。观察2组总体治疗效果、平均手术时间、平均住院时间、术后72 h疼痛情况、术后肛门功能及术后并发症等方面。结果 2组总体治疗效果差异无统计学意义(P>0.05);观察组平均手术时间、平均住院时间、术后72 h疼痛平均评分及术后肛门功能平均评分均低于对照组,差异有统计学意义(P<0.05);观察组术后并发出血及肛门坠涨的病例少于对照组,差异有统计学意义(P<0.05),2组在复发、直肠狭窄及肛门失禁等方面比较差异无统计学意义(P>0.05)。结论痔上黏膜环形切除钉合术与传统黏膜折叠术相比,具有手术时间短、患者痛苦少、术后并发症少、住院时间短、安全性高等特点,可成为经肛治疗直肠黏膜脱垂的首选方法。Objective To observe the clinical efficacy of procedure for prolapse and hemorrhoids （PPH） for treatment of rectal mucosa prolapse. Methods The 100 patients who suffered from rectal mucosa prolapse and were planning to take surgical treatment for the first time in our hospital from June 2013 to June 2015 were randomly divided into the treatment group and the control group. Patients in the treatment group （n = 50） underwent PPH while patients in the control group （n = 50 ） underwent traditional simplified mucosal plication technique. To observe the therapeutic effect of the two groups, the average operation time, average length of stay in hospital, postoperative pain within 72 hours, postoperative anal function and postoperative complications of the two groups, Results There was no significant difference in the overall treatment effect between the two groups（ P 〉 0.05 ）. The average operation time, average length of stay in hospital, postoperative pain with- in 72 hours and postoperative anal function of the treatment group were lower than those of the control group, and the differences were significant （ P 〈 O. 05 ）. Bleeding and anal bearing-down occurred much less in the treatment group compared with the control group, and the differences were statistically significant（ P 〈 0.05 ）. But there was no significant difference in postoperative complications such as recurrence, rectal stenosis and anal incontinence （P 〉 0.05 ）. Conclusion Compare to the traditional simplified mucosal plication technique, PPH technique has more advantages such as shorter operation time, less anguish of patients, less complication, shorter hospitalization time, and higher security, which indicates PPH could become the preferred method for treatment of rectal mucosa prolapse.

关 键 词：痔上黏膜环形切除钉合术 吻合器 直肠黏膜脱垂 黏膜折叠术 

分 类 号：R61[医药卫生—外科学] R574.63[医药卫生—临床医学]