经肛弧形切割闭合器治疗直肠前突的临床效果  

Clinical effect of transanal contour-curved stapler in the treatment of rectocele

作　　者：赵亮[1] 王志刚[1] 袁和学[2] ZHAO Liang;WANG Zhigang;YUAN Hexue(Five Treatment Area,Colorectal and Anal Wards,Shenyang Anorectal Hospital,Liaoning Province,Shenyang110000,China;Three Treatment Area,Colorectal and Anal Wards,Shenyang Anorectal Hospital,Liaoning Province,Shenyang110000,China)

机构地区：[1]沈阳市肛肠医院结直肠肛门病区五疗区,辽宁沈阳110000 [2]沈阳市肛肠医院结直肠肛门病区三疗区,辽宁沈阳110000

出　　处：《中国医药导报》2021年第8期126-129,共4页China Medical Herald

基　　金：辽宁省自然科学基金项目(20170540840)。

摘　　要：目的研究经肛弧形切割闭合器(CCS)直肠前壁部分切除术治疗直肠前突的临床效果。方法选取2018年1月—2020年1月沈阳市肛肠医院接受经肛CCS直肠前壁部分切除术治疗的40例成年女性直肠前突患者作为研究对象,通过排便梗阻综合征(ODS)评分、疗效评估及影像学改善情况和患者满意度调查来评价术后出口梗阻状况及手术效果。结果40例患者手术顺利,手术时间为25~40 min,平均(32±4)min,术中出血量为10~30 mL,平均(20±5)mL。术后直肠前突体征均明显降低,无大出血、直肠阴道瘘、直肠狭窄、肛门狭窄、肛周脓肿等并发症及围术期死亡病例。术后患者ODS评分较术前明显降低(P<0.05);术后患者直肠前突深度较术前明显缩短(P<0.05)。疗效评估:痊愈5例,显效15例,有效20例,无效0例,总有效率为100%。术后患者满意度调查:满意24例,基本满意16例,不满意0例。结论经肛CCS直肠前壁部分切除术是治疗以直肠前突为主的ODS的有效术式,具有安全、简便、手术时间短、术后并发症少等特点。Objective To study clinical effect of partial resection of rectum anterior wall of transanal contour-curved stapler(CCS)in the treatment of rectocele.Methods From January 2018 to January 2020,40 adult females with rectocele in Shenyang Anorectal Hospital received partial resection of rectum anterior wall of transanal CCS were selected as research objects.The status of postoperative outlet obstruction and the effect of operation were evaluated through obstruction defecation syndrome(ODS)score,efficacy evaluation,imaging improvement and satisfaction of patient survey.Results Forty cases were operated successfully,the operation time was 25 to 40 minutes,the average operation time was(32±4)minutes.The blood loss was 10 to 30 milliliters,and the average blood loss was(20±5)milliliters.The signs of rectocele decreased significantly after operation.There were no complications such as massive hemorrhage,rectovaginal fistula,rectal stricture,anal stricture,perianal abscess and perioperative death.The postoperative ODS score was significantly lower than that before operation(P<0.05).The depth of rectocele after operation was significantly shorter than that before operation(P<0.05).Curative effect evaluation:five cases were cured,15 cases were markedly effective,20 cases were effective,no one was invalid,the total effective rate was 100%.Postoperative patient satisfaction survey:24 cases were satisfied,16 cases were basically satisfied,and no one was dissatisfied.Conclusion Partial resection of rectum anterior wall of transanal CCS is an effective method for the treatment of ODS with rectocele,which is characterized as safe,simple,short operation time and less postoperative complications etc.

关 键 词：直肠前突 弧形切割闭合器 便秘 临床效果 

分 类 号：R657.1[医药卫生—外科学]