肛门内括约肌松解术在直肠前突治疗中的临床应用进展  

Progress in clinical application of internal anal sphincteral lysis in the treatment of rectocele

作　　者：王梦杰 王小峰[2] 樊志敏[2] WANG Mengjie;WANG Xiaofeng;FAN Zhimin(Graduate School of Nanjing University of Traditional Chinese Medicine,Jiangsu Nanjing 210000,China;Anorectal Department of Nanjing Hospital of Traditional Chinese Medicine,Affiliated to Nanjing University of Traditional Chinese Medicine,Jiangsu Nanjing 210000,China)

机构地区：[1]南京中医药大学研究生院,江苏南京210000 [2]南京中医药大学附属南京中医院肛肠科,江苏南京210000

出　　处：《临床普外科电子杂志》2022年第3期29-31,79,共4页Journal of General Surgery for Clinicians(Electronic Version)

基　　金：江苏省第15批“六大人才高峰”高层次人才选拔培养项目(TD-SWYY-015)。

摘　　要：直肠前突本质上为直肠阴道膈薄弱导致的阴道后壁疝,50岁以上的女性患病率为30%~50%,其突出的临床表现有排便困难、排便不尽感,时常伴有会阴区坠胀不适,更有患者经常手助排便。长期忍受这些病症的折磨,给患者心理和身体造成极大的负担。中重度直肠前突保守治疗效果不佳,患者最终选择手术治疗加强薄弱有缺陷的直肠阴道膈以及消除异常前突结构,目前临床研究报道联合内括约肌松解术治疗直肠前突效果显著,但选择该术式的适应证尚不明确,本文主要针对内括约肌松解术在直肠前突手术治疗中的应用进展进行综述,进一步明确该术式的适应证,为术者给直肠前突患者选择最佳术式提供参考。Rectocele is essentially a posterior vaginal wall hernia caused by a weak rectovaginal septum,The prevalence rate of women over 50 years old is 30%~50%.Its outstanding clinical manifestations are difficulty in defecation,a sense of incomplete defecation,and often accompanied by distension and discomfort in the perineal area,some patients often help defecate by hand.Enduring the torment of these syndromes for a long time causes great burden to patients psychologically and physically.The conservative treatment of moderate and severe rectocele is not effective,and the patients finally choose surgical treatment to strengthen the weak and defective rectovaginal septum and eliminate the abnormal protrusion structure.At present,clinical studies have reported that combined with internal sphincteral lysis is effective in the treatment of rectocele,but the indication of this operation is not clear.This article mainly reviews the progress of the application of internal sphincteral lysis in the surgical treatment of rectocele,to further clarify the indications of this operation,and to provide a reference for operators to choose the best operation for patients with rectocele.

关 键 词：直肠前突 内括约肌松解术 临床进展 

分 类 号：R73[医药卫生—肿瘤]