腹腔镜盆底修复直肠悬吊联合PPH治疗直肠黏膜内脱垂的疗效评价  

Clinical effect of laparoscopic rectal suspension with basin repair combined with the PPH for rectal internal mucosal prolapse

作　　者：王超[1] 杨阳[2] 杨维维[2] 曹永丽[2] 魏东[2] Wang Chao;Yang Yang;Yang Weiwei;Cao Yongli;Wei Dong(Department of Anus &Intestine Surgery, Sanmenxia Central Hospital, Sanmenxia 472000, China;Institute of Anal-Colorectal Surgery, No.150 Central Hospital of PLA, Luoyang 471031, China)

机构地区：[1]三门峡市中心医院肛肠科,472000 [2]中国人民解放军第150中心医院肛肠外科研究所,洛阳471031

出　　处：《中华结直肠疾病电子杂志》2017年第6期484-487,共4页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：河南省医学科技攻关计划项目(No.2011030031)

摘　　要：目的研究腹腔镜盆底修复直肠悬吊联合PPH术治疗直肠黏膜内脱垂的临床疗效。方法选择2011年3月至2012年11月手术治疗的直肠黏膜内脱垂患者94例,按手术方式分为两组。A组共48例,实施腹腔镜盆底修复直肠悬吊联合PPH术,B组46例实施PPH术。术后24个月分别对两组患者Longo和Wexner评分、术后有效率、并发症等情况进行分析。结果 A、B两组Longo评分平均值术前分别为15.39±4.15、14.86±3.06,术后24个月降至5.37±0.87、7.84±1.23。A组(t=16.37,P<0.01)和B组(t=14.46,P<0.01)组内术前、术后比较差异有统计学意义。术后24个月A组Longo评分平均值显著低于B组评分(t=-11.28,P<0.01),差异具有统计学意义。A、B两组Wexner评分平均值术前分别为14.25±3.37、14.58±3.14,术后24个月降至4.85±0.51、7.52±0.94。A组(t=19.11,P<0.01)和B组(t=14.61,P<0.01)组内术前、术后比较差异有统计学意义。术后24个月A组Wexner评分平均值显著低于B组评分(t=-17.21,P<0.01),差异具有统计学意义。两组有效率比较差异有统计学意义(χ~2=5.84,P<0.05),两组术后并发症比较差异无统计学意义(χ~2=0.20,P>0.05)。结论腹腔镜盆底修复直肠悬吊联合PPH术治疗直肠黏膜内脱垂的短期效果较单用PPH术好,但远期疗效需要进一步研究。Objective To analyze clinical efficacy of laparoscopic rectal suspension with basin repair combined with the PPH for rectal internal mucosal prolapse.Methods From March2011to November2012,94cases of patients who had internal rectal mucosal prolapse were treated.Patients were divided into two groups in terms of different surgical techniques.Group A(n=48)received laparoscopic rectal suspension with basin repair combined with the PPH,Group B(n=46)received PPH.Longo Score and Wexner Score,postoperative effect,postoperative complications in the two groups were assessed respectively before surgery and24months after surgery.Results The average preoperative Longo score of A,B two groups were15.39±4.15、14.86±3.06,after24months fell to5.37±0.87、7.84±1.23.Group A(t=16.37,P<0.01)and group B(t=14.46,P<0.01)within the group of preoperative and postoperative comparative difference was statistically significant.Average Longo score of group A after24months were significantly lower than those of group B(t=-11.28,P<0.01),the difference was statistically significant.The average preoperative Wexner score of A,B two groups were14.25±3.37、14.58±3.14,after24months fell to4.85±0.51、7.52±0.94.Group A(t=19.11,P<0.01)and group B(t=14.61,P<0.01)within the group of preoperative and postoperative comparative difference was statistically significant.Average Wexner score of group A after24months were significantly lower than those of group B(t=-17.21,P<0.01),the difference was statistically significant.The total effective rate among the two groups was statistically significant(χ2=5.84,P<0.05).The complications of two groups were not statistically insignificant(χ2=0.20,P>0.05).Conclusion The short term efficacy of laparoscopic rectal suspension with basin repair combined with the PPH is better than PPH,but the long term effect need further research.

关 键 词：直肠 直肠悬吊 直肠黏膜内脱垂 盆底修复 

分 类 号：R657.1[医药卫生—外科学]