经肛吻合器直肠切除术治疗直肠前突的临床效果及对患者直肠动力功能指标的影响  

Clinical effect of stapled transanal rectal resection in the treatment of rectocele and its influence on rectal motility function indexes of patients

作　　者：申虎伟 张光银 李亚军 SHEN Huwei;ZHANG Guangyin;LI Yajun(Zichang People's Hospital of Yan'an,Yan'an 717300;Yan'an City Hospital of TCM,Yan'an 716000,China)

机构地区：[1]陕西省延安市子长市人民医院,陕西延安717300 [2]延安市中医医院,陕西延安716000

出　　处：《临床医学研究与实践》2022年第27期81-84,共4页Clinical Research and Practice

摘　　要：目的探讨经肛吻合器直肠切除术治疗直肠前突的临床效果及对患者直肠动力功能指标的影响。方法选取2019年2月至2021年3月于本院诊治的50例直肠前突患者作为研究对象,采用随机数字表法将其分为修补组和切除组,各25例。修补组采用肛门直肠修补术治疗,切除组采用经肛吻合器直肠切除术治疗。比较两组的治疗效果。结果切除组的手术时间、术后住院时间短于修补组,术中出血量少于修补组,术后2 h的视觉模拟评分法(VAS)评分低于修补组(P<0.05)。术后,两组的最大肛门括约肌收缩压(MASP)、最大肛管静息压(MARP)均减小,肛门括约肌功能长度均缩短,缩榨持续时间均延长,直肠排便压均升高,且切除组优于修补组(P<0.05)。切除组的并发症总发生率、术后Longo ODS评分均低于修补组(P<0.05)。术后,两组的便秘患者生活质量量表(PAC-QOL)各维度评分及总分均降低,且切除组低于修补组(P<0.05)。结论与肛门直肠修补术相比,选用经肛吻合器直肠切除术治疗直肠前突的临床效果更优,其可缩短手术时间,减轻机体创伤、疼痛程度、排便困难情况,改善直肠动力功能指标,降低并发症发生率,并提高患者的生活质量。Objective To investigate the clinical effect of stapled transanal rectal resection in the treatment of rectocele and its influence on rectal motility function indexes of patients.Methods A total of 50 patients with rectocele diagnosed and treated in our hospital from February 2019 to March 2021 were selected as the study objects.The patients were divided into repair group and resection group by random number table method,with 25 cases in each group.The repair group was treated with anorectal repair,and the resection group was treated with stapled transanal rectal resection.The therapeutic effects of the two groups were compared.Results The operation time and postoperative hospital stay in the resection group were shorter than those in the repair group,the intraoperative blood loss was less than that in the repair group,and the Visual Analogue Scale(VAS)score at 2 h after operation was lower than that in the repair group(P<0.05).After operation,the maximum anal systolic pressure(MASP)and maximum anal resting pressure(MARP)in the two groups decreased,the anal sphincter function length shortened,the squeeze duration prolonged,and the rectal defecation pressure increased,and those in the resection group were better than the repair group(P<0.05).The total incidence of complications and the postoperative Longo ODS score in the resection group were lower than those in the repair group(P<0.05).After operation,the scores of each dimension and total score of Patient Assessment of Constipation Quality of Life Question(PAC-QOL)in the two groups decreased,and those in the resection group were lower than the repair group(P<0.05).Conclusion Compared with anorectal repair,stapled transanal rectal resection has a better clinical effect in the treatment of rectocele.It can shorten the operation time,alleviate the body trauma,pain degree and defecation difficulty,ameliorate the rectal motility function indexes,reduce the incidence of complications and improve the quality of life of patients.

关 键 词：直肠前突 肛门直肠修补术 经肛吻合器直肠切除术 直肠动力功能 最大肛门括约肌收缩压 

分 类 号：R657.1[医药卫生—外科学]