经肛吻合器直肠切除术治疗女性出口梗阻型便秘临床效果观察  

Therapetic effect of stapled transanal rectal resection on female outlet obstructive constipation

作　　者：徐乐臣 沈家华[1] 杨新庆[2] XU Lechen;SHEN Jiahua;YANG Xinqing(Department of Anorectal Surgery,Beijing Aerospace General Hospital,Beijing 100076,China;Department of General Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100027,China)

机构地区：[1]北京航天总医院肛肠科,北京100076 [2]首都医科大学朝阳医院普外科,北京100027

出　　处：《中国医学物理学杂志》2021年第4期480-484,共5页Chinese Journal of Medical Physics

摘　　要：目的:探讨经肛吻合器直肠切除术(STARR)治疗以直肠前突(或合并直肠黏膜内脱垂)为主的女性出口梗阻型便秘的临床疗效。方法:简介手术所用的肛肠吻合器。对58例以直肠前突(或合并直肠粘膜内脱垂)为主要病因的女性出口梗阻型便秘患者实施STARR手术前后的主观感受、便秘评分、排粪造影进行分析比较。结果:术后所有病人主观感觉排便困难症状缓解,排便较术前畅通;术后1周、1月、3月与术前便秘评分比较差异有统计学意义(P<0.05);术后1、3月排粪造影结果提示直肠前突、直肠黏膜内脱垂较术前明显好转(P<0.01)。结论:STARR手术是治疗以直肠前突(或合并直肠粘膜内脱垂)为主因的女性出口梗阻型便秘的一个安全有效的手术方式,但应严格掌握其适应证。Objective To investigate the therapeutic effect of stapled transanal rectal resection(STARR)on female outlet obstructive constipation(OOC)which is mainly caused by rectocele(or combined with rectal mucosal prolapse).Methods The stapler used in transanal rectal resection was introduced briefly.The subjective feeling,Longo score and defecography of 58 female patients before and after STARR for OOC mainly caused by rectocele(or combined with rectal mucosal prolapse)were analyzed and compared.Results After surgery,all patients felt that the symptom of difficult defecation was relieved,and the defecation was smoother than pre-surgery.Compared with that before surgery,the Longo scores at 1 week,1 month and 3 months after surgery were significantly lower,with statistical differences(P<0.05).The results of defecography at 1 month and 3 months after surgery suggested that rectocele and rectal mucosal prolapse were obviously better than pre-surgery(P<0.01).Conclusion STARR is a safe and effective procedure for the treatment of female OOC which is mainly caused by rectocele(or combined with rectal mucosal prolapse),but its surgical indications should be strictly grasped.

关 键 词：经肛吻合器直肠切除术 出口梗阻型便秘 直肠前突 直肠粘膜内脱垂 

分 类 号：R657.1[医药卫生—外科学]