改良腹腔镜腹侧直肠补片固定术在女性重度直肠脱垂中的应用  

Application of modified laparoscopic ventral rectal patch fixation in female with severe rectal prolapse

作　　者：谢雅 闫文锋 夏晓博 XIE Ya;YAN Wen-feng;XIA Xiao-bo(Department of Gastrointestinal Surgery,Hennan Provincial People's Hospital(People's Hospital of Zhengzhou University),Zhengzhou 450000,China)

机构地区：[1]河南省人民医院(郑州大学人民医院)胃肠外科,郑州450000

出　　处：《医药论坛杂志》2022年第22期19-22,共4页Journal of Medical Forum

基　　金：河南省医学科技攻关计划项目(201702166)。

摘　　要：目的探讨改良腹腔镜辅助下经腹侧直肠补片固定术对女性直肠脱垂的治疗临床疗效回顾性分析。方法回顾性分析河南省人民医院2017年10月至2020年10月行改良腹腔镜腹侧直肠补片固定术治疗的15例女性重度直肠脱垂的患者临床资料设为治疗组,对照组选取同期我科女性重度直肠脱垂患者15例行Altemeiers术,观察两组病人的手术时间、术中出血量、住院时间等进行综合分析,随访其近期临床疗效并进行比较。结果治疗组15例患者手术时间与对照比较差异无统计学意义,而手术中出血量、住院时间及住院费用比较差异有统计学意义(P<0.05),治疗组(6.7%)发生并发症的概率低于对照组(33.3%)。术后两组均未出现腹腔感染、直肠狭窄及穿孔等严重并发症,随访观察期间未见复发,术后Bristol粪便评分及Wexner便秘评分明显优于术前,两组患者术后Bristol粪便性质评分及Wexner便秘评分比较;差异均具有统计学意义(P<0.05)。结论改良腹腔镜腹侧直肠补片固定术技术操作安全,手术创伤小,术后恢复快,疗效较好,能有效的防止术后病情的复发,值得临床推广应用。Objective To discuss the clinical effect of modified laparoscopic ventral rectal patch fixation in the treatment of female rectal prolapse.Methods The clinical data of 15 female patients with severe rectal prolapse who were treated with modified laparoscopic ventral rectal patch fixation in Hennan Provincial People’s Hospital from October,2017 to October,2020 were retrospectively analyzed.In the control group,15 women with severe rectal prolapse were treated with altemeiers.The operation time,intraoperative blood loss,hospitalization time,etc were observed,clinical efficacy of recent patients were followed up and compared.Results Compared with other surgical methods,the amount of bleeding during opration,hospitalization time and hospitalization expenses were significantly different(P<0.05),the rate of complications in the treatment group(6.7%)was lower than that of the control group(33.3%),the Bristol constipation score and the Wexner constipation score were obviously better than those of the control group.Conclusion The modified laparoscopic ventral rectal patch fixation technique is more safe to operate,has smaller surgical trauma,quicker postoperative recovery,better curative effect,also can effectively prevent postoperative recurrence,so it is worthy of promoting this clinical application.

关 键 词：腹侧直肠补片固定术 重度直肠脱垂 

分 类 号：R657.1[医药卫生—外科学]