经直肠双侧耻骨直肠肌部分松解术治疗肛管高压性出口梗阻性便秘的疗效分析  

作　　者：陈文轩 刘扬[1] 华锋 路明[1] 

机构地区：[1]新疆医科大学第一附属医院,830054

出　　处：《浙江临床医学》2019年第11期1511-1512,共2页Zhejiang Clinical Medical Journal

摘　　要：目的 分析经直肠双侧耻骨直肠肌部分松解术治疗肛管高压性出口梗阻性便秘的临床疗效.方法 将2014年3月至2017年12月明确诊断为肛管高压性出口梗阻性便秘患者106例,按照随机数字表法分为双侧耻骨直肠肌部分松解术53例(观察组),经骶尾韧带行6点位耻骨直肠肌离断术53例(对照组),术后6个月对入组患者的肛门直肠测压、排粪造影、双侧耻骨直肠肌平均厚度、排便时间、排便不净感、排便次数等相关指标进行前瞻性观察.结果 与对照组相比,观察组肛门静息压、肛管高压带长度、双侧耻骨直肠肌平均厚度、排便时间均降低,力排期肛门直肠角、排便次数均增高(P≤0.05),两组患者肛管最大收缩压、直肠静息压、排便紧迫感差异无统计学意义(P>0.05).结论 经直肠双侧耻骨直肠肌部分松解术治疗肛管高压性出口梗阻性便秘疗效显著,可减轻肛管高压带长度,缓解出口梗阻便秘症状.Objective To investigate the clinical effect of partial resection of bilateral puborectal muscle of the rectum for the treatment of anal canal hypertension obstructive constipation.Methods From March 2014 to December 2017,106 patients with anal canal hypertension obstructive constipation diagnosed clearly in the first affiliated hospital of Xinjiang Medical University were randomly divided into partial resection of bilateral puborectal muscle of 53 cases(study group),partial resection of puborectal muscle through the Tail ligament at 6 o'clock position 53 cases(control group),in the random number table method.Through preoperative and 6 months after surgery,the patients were measured in the anorectal manometry,defecation angiography,average thickness of bilateral puborectalis muscles,defecation time,incomplete defecation,and the number of defecations and detect relevant indicators.Results Compared with the control group,the group of partial resection of bilateral puborectal muscle of the rectum that about the anal resting pressure,the length of high pressure belt of the anal canal,the average thickness of the bilateral puborectal muscles,and the time of defecation were reduced.In addition,anal rectal angle during forced defecation period and the number of defecations were increased in both(P≤0.05),There was no significant difference in anal canal maximum systolic pressure,rectal resting pressure and urgency of defecation between the two groups(P>0.05).Conclusion Significant treatment effect of partial resection of bilateral puborectal muscle of the rectum in the treatment of export obstructive constipation with high anal pressure,that way can reduce the length of high pressure belt of the anal canal,relieve the symptoms of export obstruction constipation.

关 键 词：耻骨直肠肌 出口梗阻性便秘 肛门直肠测压 排粪造影 前瞻性研究 

分 类 号：R73[医药卫生—肿瘤]