经阴道修补联合痔上黏膜环切术治疗直肠前突的疗效  

Efficacy of transvaginal repair combined with procedure for prolapse and hemorrhoids in the treatment of rectal protrusion

作　　者：岳中屹[1] 李秀庚 雒红涛 张敏[1] 赫鹏[1] YUE Zhongyi;LI Xiugeng;LUO Hongtao(Department of Colorectal and Anal Surgery,First Affiliated Hospital,Xinxiang Medical University,Weihui 453100,CHINA)

机构地区：[1]新乡医学院第一附属医院结直肠肛门外科,河南卫辉453100

出　　处：《江苏医药》2020年第12期1263-1266,共4页Jiangsu Medical Journal

基　　金：河南省医学科技攻关计划(201702124);新乡医学院第一附属医院青年培育基金(QN-2019-B13)。

摘　　要：目的观察经阴道修补联合痔上黏膜环切术(PPH)治疗直肠前突的疗效。方法直肠前突患者204例分别行经阴道修补联合PPH术(联合手术组,101例)和单纯PPH手术(单纯手术组,103例)。比较两组围手术期指标和术后并发症,术前及术后3、6、9、12、18个月使用Longo评分评估两组便秘情况,比较两组术后12、18个月疗效及复发率。结果与单纯手术组比较,联合手术组手术时间延长[(48.85±7.64)min vs.(30.85±6.53)min],术中出血量增加[(48.58±16.24)mL vs.(20.03±9.17)mL](P<0.01)。两组术后各时间点Longo评分均较术前下降(P<0.05)。术后12、18个月联合手术组Longo评分低于单纯手术组(P<0.05)。与单纯手术组比较,联合手术组术后12、18个月总有效率增高,复发率降低(P<0.05)。结论经阴道修补联合PPH治疗直肠前突安全有效,且远期疗效优。Objective To observe the efficacy of transvaginal repair combined with procedure for prolapse and hemorrhoids(PPH)in the treatment of rectal protrusion.Methods Rectal protrusion of 204 patients was repaired with PPH alone(group C,103 cases)or combined with transvaginal repair(group A,101 cases).The perioperative indicators and postoperative complications of two groups were compared.Longo scale was used to evaluate the constipation of two groups before and in the 3rd,6th,9th,12th and 18th month after surgery.The efficacy and recurrence rates of two groups were compared in the 12th and 18th month after surgery.Results Compared with group C,group A had a longer operation time[(48.85±7.64)minutes vs.(30.85±6.53)minutes]and more intraoperative blood loss[(48.58±16.24)mL vs.(20.03±9.17)mL](P<0.01).Postoperative Longo scores at all time points in both groups were decreased compared with those before surgery(P<0.05).Longo scores in group A were lower than those in group C in the 12th and 18th month after surgery(P<0.05).Compared with group C,the total effective rates were increased,but recurrence rates were decreased in group A in the 12th and 18th month after surgery(P<0.05).ConclusionTransvaginal repair combined with PPH is safe and effective with better long-term effect in the treatment of rectal protrusion.

关 键 词：直肠前突 经阴道修补术 痔上黏膜环切术 

分 类 号：R657[医药卫生—外科学]