PPH联合RPH治疗直肠前突合并直肠黏膜内脱垂疗效观察  

Efficacy of PPH Combined with RPH in the Treatment of Rectocele Complicated with Internal Rectal Mucosal Prolapse

作　　者：许成[1] 张育葵 Xu Cheng;Zhang Yukui(Department of Proctology,Xiangyang Hospital of Traditional Chinese Medicine,Hubei University of Chinese Medicine,Xiangyang,Hubei 441000,China)

机构地区：[1]湖北中医药大学附属襄阳市中医医院肛肠科,湖北襄阳441000

出　　处：《中国烧伤创疡杂志》2021年第6期443-446,共4页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的观察痔上黏膜环切术(PPH)联合弹力线套扎术(RPH)治疗直肠前突合并直肠黏膜内脱垂的临床疗效。方法选取2017年2月至2020年2月湖北中医药大学附属襄阳市中医医院收治的100例直肠前突合并直肠黏膜内脱垂女性患者作为研究对象,并按照随机数表法将其随机分为治疗组50例和对照组50例,治疗组患者行PPH联合RPH治疗,对照组患者行单纯PPH治疗,对比两组患者临床疗效以及排便、疼痛及生活质量评分变化情况。结果术后1个月,治疗组患者中痊愈15例、显效20例、有效14例、无效1例,明显优于对照组患者的痊愈7例、显效17例、有效19例、无效7例(Z=-2.700,P=0.007);术后1、3、6个月,治疗组患者Longo出口梗阻型便秘(Longo ODS)评分表评分、视觉模拟评分法(VAS)评分及便秘患者生活质量量表(PAC-QOL)评分均明显低于对照组(Longo ODS评分:t=13.529、20.280、22.380,P均<0.001;VAS评分:t=18.836、24.267、25.101,P均<0.001;PAC-QOL评分:t=8.796、21.704、23.952,P均<0.001)。结论PPH联合RPH治疗直肠前突合并直肠黏膜内脱垂能够显著提高患者临床疗效,减轻患者疼痛程度,改善患者生活质量,值得临床推广应用。Objective To observe the clinical efficacy of Procedure for Prolapse and Hemorrhoids(PPH)combined with Ruiyun Procedure for Hemorrhoids(RPH)in the treatment of rectocele and internal rectal mucosal prolapse.Methods 100 female patients with rectocele and internal rectal mucosal prolapse,admitted to the Xiangyang Hospital of Traditional Chinese Medicine Affiliated to Hubei University of Chinese Medicine from February 2017 to February 2020,were enrolled and divided,using random number table,into treatment group(n=50)treated with PPH combined with RPH and control group(n=50)treated with PPH only.The clinical efficacy,defecation,pain and quality of life were compared between the two groups.Results One month after surgery,in treatment group,15 cases were cured,20 cases were markedly effective,14 cases were effective,and 1 case was ineffective,significantly better than control group(Z=-2.700,P=0.007)in which 7 cases were cured,17 cases were markedly effective,19 cases were effective and 7 cases were ineffective.On month 1,3,and 6 after surgery,the scores of Longo obstructed defecation syndrome(ODS)scale,of visual analog scale(VAS)and of PAC-QOL(patient assessment of constipation-quality of life)questionnaire in treatment group were all significantly lower than control group(Longo ODS score:t=13.529,20.280,22.380,all P<0.001;VAS score:t=18.836,24.267,25.101,all P<0.001;PAC-QOL score:t=8.796,21.704,23.952,all P<0.001).Conclusion PPH combined with RPH in the treatment of rectocele combined with internal rectal mucosal prolapse can significantly improve clinical efficacy,reduce patients’pain,and improve their quality of life,deserving to be promoted in clinical practice.

关 键 词：痔上黏膜环切术 弹力线套扎术 直肠前突 直肠黏膜内脱垂 出口梗阻型便秘 

分 类 号：R657.1[医药卫生—外科学]