选择性痔上黏膜环切术对直肠内套叠的临床疗效观察  

Observation of curative effect of tissue-selecting therapy stapler on treating internal rectal prolapse

作　　者：鞠曼 夏超锋[1] 刘文慧[2] 郑万磊[3] 董典博 史甜 Ju man;Xia Chaofeng;Liu Wenhui;Zheng Wanlei;Dong Dianbo;Shi Tian(Department of Anorectal Surgery,Liaocheng People′s Hospital,Liaocheng 252000,China;Department of Dermatology,Liaocheng People′s Hospital,Liaocheng 252000,China;Gastrointestinal Surgery,Liaocheng People′s Hospital,Liaocheng 252000,China)

机构地区：[1]聊城市人民医院肛肠外科1,252000 [2]聊城市人民医院皮肤科,252000 [3]聊城市人民医院胃肠外科,252000

出　　处：《中华结直肠疾病电子杂志》2019年第6期602-605,共4页Chinese Journal of Colorectal Diseases(Electronic Edition)

摘　　要：目的分析选择性痔上黏膜环切术(TST)对直肠内套叠造成的出口梗阻性便秘的临床疗效。方法收集聊城市人民医院肛肠外科于2013年1月至2015年1月期间收治的200例直肠内套叠的临床资料,根据术式分为选择性痔上黏膜环切术(TST)组(n=100)和痔上黏膜环切钉合术(PPH)组(n=100),比较两组患者的临床疗效及住院时间,同时对术后疼痛、尿潴留、出血、肛门坠胀、吻合口狭窄等并发症的发生情况进行比较。结果TST组与PPH组患者有效率分别为81%和79%,差异无统计学意义(χ^2=0.13,P>0.05);TST组患者住院时间明显少于PPH组(χ^2=35.24,P<0.01);除术后6小时以外,TST组术后疼痛(χ^224 h=5.71,χ^248 h=5.38,χ^272 h=7.73;P<0.05)、尿潴留(χ^2=9.28,P<0.05)、出血(χ^2=7.04,P<0.01)、肛门坠胀(χ^2=23.86,P<0.01)、吻合口狭窄(χ^2=23.46,P<0.01)等并发症的发生率均明显低于PPH组,比较差异有统计学意义。结论TST治疗直肠内套叠临床疗效显著,且住院时间短,术后并发症少。Objective To observe clincal curative effect of tissue-selecting therapy stapper(TST) on treating internal rectal prolapse.Methods The clinical data of 200 patients with internal rectal prolapse of Liaocheng People′s Hospital Anorectal Department from January 2013 to January 2015 were collected and divided into TST group(n=100)and PPH group(n=100)according to the surgical methods.The clinical efficacy and hospitalization time of the two groups were compared.The postoperative pain,urinary retention,bleeding,anal swelling and anastomotic stenosis were also compared.Results The curative effects of TST group and PPH one were 81%and 79%,respectively,with no significant difference(χ^2=0.13,P>0.05);hospitalization time of TST group was significantly less than that of PPH group(χ^2=35.24,P<0.01);Postoperative pain(χ^224 h=5.71,χ^248 h=5.38,χ^272 h=7.73;P<0.05),urinary retention(χ^2=9.28,P<0.05),bleeding(χ^2=7.04,P<0.01),anastomotic stenosis(χ^2=23.46,P<0.01),anal swelling(χ^2=23.86,P<0.01)in TST group were all significantly lower than that in PPH one,except for 6 hour pain after surgery.Conclusion TST is effective in the treatment of rectal intussusception,with shorter hospitalization time and fewer postoperative complications.

关 键 词：便秘 肛管 直肠 直肠内套叠 TST术 PPH术 临床疗效 

分 类 号：R65[医药卫生—外科学]