经阴道修补和痔上黏膜环切术治疗直肠前突性便秘临床疗效的比较  

Comparison of transvaginal repair and PPH for the treatment of rectocele

作　　者：邹劲林[1] 彭培建[2] 莫湘琼[1] ZOU Jinlin;PENG Peijian;MO Xiangqiong(Department of Gastroenterology, the Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China)

机构地区：[1]中山大学附属第五医院胃肠外科,广东珠海519000 [2]中山大学附属第五医院肿瘤化疗科,广东珠海519000

出　　处：《实用医学杂志》2018年第6期995-997,1002,共4页The Journal of Practical Medicine

摘　　要：目的探讨直肠前突所致出口梗阻型便秘(ODS)患者经直肠下端黏膜环切术(PPH)和经阴道修补加强直肠阴道隔治疗后直肠前突的临床疗效。方法选择87例直肠前突患者,按照随机原则分为A和B组,分别采用经阴道修补和PPH方式修补治疗。比较其疗效和Longos ODS评分、手术时间、术中出血量、术后疼痛评分、需用止痛药次数、住院时间、住院费用。结果 B组1和3个月痊愈加显效率分别为:87.5%和90%优于A组(77.5%和80%,P<0.05),住院费用B组高于A组,住院时间,术中出血两组无统计学差异外,上述其余指标B组均优于A组(P<0.05)。结论两种术式均可取得良好的治疗效果,手术成败关键时彻底消除直肠阴道之间的薄弱区,尽可能加强支持的同时,勿引起直肠和阴道的狭窄。相对于经阴道而言,笔者认为PPH在处理直肠前突引起便秘时更加彻底,疗效更加显著。Objective To investigate the clinical efficacy of PPH and vaginal repair to strengthen recto-cele in the treatment of ODS patients. Methods 87 patients with rectocele were divided into and groups A and Baccording to the principle of randomization. They were treated by vaginal repair and PPH repair respectively. Thetwo groups were compared in term of curative effect and Longo′s ODS score,operation time,intraoperative bloodloss,postoperative pain score,the number of analgesics needed,hospitalization time and hospitalization expenses.Results The heal rates together with marked efficacy rate at months 1 and 3 in group B were significantly higherthan those of group A（87.5%,90% vs. 77.5%,80%,P〈0.05）. There were no differences in hospital stay and in-traoperative blood loss. Group B was significantly superior to group A in postoperative pain score,number of analge-sics needed and hospitalization expenses. Conclusion PPH is more complete and more effective in treating consti-pation caused by RC.

关 键 词：直肠前突 手术 疗效 

分 类 号：R657.1[医药卫生—外科学]