直肠黏膜高位缝扎低位环切术治疗中、重度直肠内脱垂型排便障碍的临床研究  

Effect of high ligation and low loop resection of rectal mucosa for moderate to severe defecation disorder due to internal rectal prolapse

作　　者：魏雨[1] 骆春梅 龚文敬[1] 蓝海波[1] 

机构地区：[1]成都肛肠专科医院便秘科,四川成都610015

出　　处：《结直肠肛门外科》2017年第6期705-709,共5页Journal of Colorectal & Anal Surgery

基　　金：成都市卫计局2014年度课题;项目编号:2014013

摘　　要：目的观察直肠黏膜高位缝扎低位环切术治疗中、重度直肠内脱垂型排便障碍的临床疗效。方法选取本院2014年1月至2014年12月收治的120例中、重度直肠内脱垂型排便障碍患者作为研究对象,随机将其分为A、B两组,每组各60例。A组采用直肠黏膜高位缝扎低位环切术,B组采用直肠黏膜环切吻合术。比较两组手术前后临床症状评分、排粪动态造影检查结果,比较两组术后并发症发生情况以及便秘的治疗效果。结果术前,两组评分差异无统计学意义(P>0.05);术后,两组组内各时点之间评分差异均有统计学意义(均P<0.05),A组各时点评分均显著低于B组,差异均有统计学意义(均P<0.05)。术前,两组排粪动态造影总体结果差异无统计学意义(P>0.05);术后,两组总体结果差异有统计学意义(P<0.05)。两组并发症总发生率差异无统计学意义(P>0.05)。A组便秘疗效总有效率显著高于B组,差异有统计学意义(P<0.05)。结论对于中、重度直肠内脱垂型排便障碍患者,直肠黏膜高位缝扎低位环切术相比于直肠黏膜环切吻合术可获得更优的临床治疗效果,安全可靠。Objective To study the clinical effect of high ligation and low ring resection of rectal mucosa in the treatment of moderate to severe defecation disorder due to internal rectal prolapse. Methods 120 patients with moderate and severe defecation disorders due to internal rectal prolapse who were treated in our hospital from January 2014 to December 2014 were recruited as study subjects. They were randomly assigned to A and B groups, with 60 cases in each group. Group A was treated with high ligation and low loop resection of rectal mucosa, and group B with rectal mucosa resection and anastomosis. The following outcomes were compared between the two groups： scores of clinical symptoms before and after surgery, defecation dynamic contrast examination, and complications. Results Before the operation, there was no significant difference in scores of clinical symptoms between the two groups（P 0.05）. After the operation, there were significant difference between the two groups at each time point（P 0.05）, with scores in group A group significantly lower than those in group B at each time point（P 0.05）. Before the operation, the two groups had no statistically significant difference in the overall results of defecation dynamic contrast（P 0.05）. After the operation, there was statistically significant differences between the two groups（P 0.05）. There was no significant difference in the total incidence of complications between the two groups（P 0.05）. The total effective rate of constipation in group A was significantly higher than that in group B（P 0.05）. Conclusion For patients with moderate and severe defecation disorder due to internal rectal prolapse, compared to rectal mucosa anastomosis, high ligation and low loop resection of rectal mucosa can obtain better curative effect, and is safe.

关 键 词：直肠内脱垂型排便障碍 直肠黏膜高位缝扎低位环切术 直肠黏膜环切吻合术 

分 类 号：R657.1[医药卫生—外科学]