STARR与PPH治疗青年男性脱垂性痔患者的临床疗效比较  

Comparison of clinical effectiveness between stapled transanal rectal resection and procedure for prolapse and hemorrhoids for young male patients with pro⁃lapsed hemorrhoids

作　　者：裴岩 高记华 戚文月 田茂生 吴琼 段冰倩 王冉 刘子毅 Pei Yan;Gao Jihua;Qi Wenyue;Tian Maosheng;Wu Qiong;Duan Bingqian;Wang Ran;Liu Ziyi(Department of Colorectal Surgery,The First Affiliated Hospital of Hebei College of Chinese Medicine,Shijiazhuang 050011,He-bei,China)

机构地区：[1]河北中医学院第一附属医院肛肠科,河北石家庄050011

出　　处：《结直肠肛门外科》2022年第5期460-464,共5页Journal of Colorectal & Anal Surgery

基　　金：河北省科技厅科研计划项目(16277758D)。

摘　　要：目的比较经肛门吻合器直肠切除术(STARR)与吻合器痔上黏膜环切钉合术(PPH)治疗青年男性脱垂性痔患者的临床疗效。方法回顾性分析2019年1月至2019年12月于河北中医学院第一附属医院肛肠科接受手术治疗的84例青年男性脱垂性痔患者的临床资料。按照手术方式的不同,分为治疗组(n=44,采用STARR)与对照组(n=40,采用PPH)。比较两组的症状改善情况,术后疼痛程度,肛门功能(Wexner肛门失禁评分),术后并发症(肛门坠胀、肛门水肿、吻合口狭窄)的发生情况,以及生活质量(SF-36评分)。结果术后12个月,治疗组症状有效改善率高于对照组(P<0.05)。术后第1天,两组VAS疼痛评分比较差异无统计学意义(P>0.05);术后第7天,治疗组VAS疼痛评分低于对照组(P<0.05)。术前,两组Wexner肛门失禁评分比较差异无统计学意义(P>0.05);术后6个月,两组Wexner肛门失禁评分低于术前,治疗组Wexner肛门失禁评分低于对照组(均P<0.05)。治疗组术后3个月内肛门坠胀、肛门水肿、吻合口狭窄的发生率均低于对照组(均P<0.05)。术前,两组SF-36各维度的评分比较差异均无统计学意义(均P>0.05);术后6个月,两组SF-36各维度的评分均高于术前,治疗组生理功能维度、生理职能维度、活力维度、精神健康维度的评分均高于对照组(均P<0.05)。结论对于青年男性脱垂性痔患者,STARR相比PPH在改善临床症状、生活质量、肛门功能,减少术后并发症,减轻术后疼痛等方面有相对优势。Objectives To compare the clinical effectiveness between stapled transanal rectal resection(STARR)and procedure for prolapse and hemorrhoids(PPH)for young male patients with prolapsed hemorrhoids.Methods This was a retrospective analysis of 84 young male patients with prolapsed hemorrhoids who were treated at the Department of Colorectal Surgery,The First Affiliated Hospital of Hebei College of Chinese Medicine,between January 2019 and December 2019.Depending on the surgical technique,patients were divided into the treatment group(receiving STARR,n=44)and the control group(receiving PPH,n=40).The follow⁃ings were compared between the two groups:rate of symptom improvement,postoperative pain,anal function(Wexner anal inconti⁃nence score),postoperative complications(anal distension,anal edema,and anal stricture),and quality of life(measured using the SF-36).Results At 12 months after surgery,the rate of symptom improvement was significantly higher in the treatment group than in the control group(P<0.05).Pain score of visual analog scale(VAS)at 1 day after surgery did not differ significantly between the two groups(P>0.05);Pain score of VAS at 7 days after surgery was significantly lower in the treatment group than in the control group(P<0.05).Preoperative Wexner anal incontinence score did not differ significantly between the two groups(P>0.05);At 6 months after surgery,Wexner anal incontinence score decreased significantly in both groups and was significantly lower in the treat⁃ment group than in the control group(P<0.05).Incidences of anal distension,anal edema,and anal stricture within 3 months after surgery were significantly lower in the treatment group than in the control group(P<0.05).Preoperative SF-36 dimension scores did not differ significantly between the two groups(P>0.05).At 6 months after surgery,SF-36 dimension scores increased significantly in both groups and the treatment group had significantly higher dimension scores of physical function,role physical,vitality,and mental health(P<0.05).Con

关 键 词：脱垂性痔 经肛门吻合器直肠切除术 吻合器痔上黏膜环切钉合术 临床疗效 

分 类 号：R657.18[医药卫生—外科学]