两种微创术式治疗重度直肠脱垂46例疗效观察  

Comparison on the Effects of Two Mini-invasive Procedure for Severe Rectocele of 46 Cases

作　　者：孙玉成 刘晓巍 片光哲 SUN Yu-cheng;LIU Xiao-wei;PIAN Guang-zhe(Coloproctological Dept.,the Affiliated Hospital to Yanbian University,Yangji,Jilin 133000)

机构地区：[1]延边大学附属医院肛肠科,吉林延吉133000

出　　处：《中国肛肠病杂志》2021年第6期59-62,共4页Chinese Journal of Coloproctology

摘　　要：为比较经腹及经会阴两种微创术式治疗重度直肠脱垂的临床效果,将46例重度直肠脱垂患者随机分成A、B 2组,每组23例。A组采用腹腔镜直肠、乙状结肠部分切除加直肠悬吊固定术治疗,B组采用经会阴改良Altemeier术治疗。比较2组手术时间、肠功能恢复时间、平均住院时间及并发症发生率等。结果显示,B组在手术时间、肠功能恢复时间、肛门控便功能改善程度、并发症发生率、平均住院时间方面均优于A组(P<0.05);在术中出血量、复发率和便秘症状方面比较,两组差异无统计学意义(P>0.05);在肛门坠胀、肛门疼痛方面,两组术后均有明显改善,且B组优于A组(P<0.05);术后肛管静息压、最大收缩压、Wexner肛门失禁评分改善方面B组均优于A组(P<0.01)。结果表明,与腹腔镜直肠、乙状结肠部分切除加直肠悬吊固定术比较,改良Altemeier术治疗重度直肠脱垂更微创、更安全有效,尤适用于术前伴有肛门失禁的患者。This study was to compare the effects of two mini-invasive procedures in the treatment of severe rectocele,randomly divided 46cases into group A,and group B,23cases for each;group A received laparo-scopic partial resection of rectum and sigmoid plus suspension&fixation of rectum(laparoscopic resection rectopexy,L RR),m eanwhile,group B,perineal modified Altemeier procedure;t hen,both groups's operating time,the time for intestinal function recovered,average hospitalization time,and complication incidece,e tc.As results,in above all items,as well as improved degree of anus-controlled defecation,group B was all su-perior to group A(P<0.05);in intraoperative bleeding volume,recurrence rate,and constipation symp-toms there was no statistical difference between the two groups(P>0.05);in anal pain and bearing-down-swelling both groups all got significantly improved,but group B was superior to group A(P<0.05);a fter surgery anal resting pressure,Max.systolic pressure,and Wexner score ratings on anal incontinence in group B got more improved than group A(P<0.05).Results show that compared to the procedure used in group A(P<0.05).Results show that compared to the procedure used in group A,the procedure used in group B is more safer,e ffective,and mini-invasive,especially,suitable to the patients with preoperatively complicated with anal incontinence in group B got more improved than group A(P<0.05).Results show that compared to the procedure used in group A,the procedure used in group B is more safer,e ffective,and mini-invasive,especially,suitable to the patients with preoperatively complicated with anal incontinence.

关 键 词：重度直肠脱垂 Altemeier术 腹腔镜手术 疗效 

分 类 号：R657.19[医药卫生—外科学]