PPH与STARR术治疗出口梗阻性便秘手术前后排粪造影的分析比较  

Analysis and Comparison of Defecography before and after PPH and STARR Surgery for Outlet obstructive Constipation

作　　者：李建凯 贾彭松 LI Jiankai;JIA Pengsong(Department of Colorectal and Anal Surgery,Anyang People's Hospital,Anyang Henan 455000,China)

机构地区：[1]安阳市人民医院结直肠肛门外科,河南安阳455000

出　　处：《临床研究》2023年第4期97-100,共4页Clinical Research

摘　　要：目的 对比分析痔上黏膜环切术(PPH)与吻合器直肠切除术(STARR)治疗出口梗阻性便秘的疗效,同时探究手术前后排粪造影相关指标的变化情况。方法 将安阳市人民医院2020年6至2022年6月收治的76例出口梗阻性便秘患者作为此次研究对象,依据为区间随机法实施开展1∶1组别划分,对照组接受STARR治疗,试验组接受PPH治疗。对比两组治疗前后便秘相关量表评分、围术期相关指标、术后并发症发生情况、排粪造影相关指标的变化情况。结果 治疗前两组各便秘量表评分对比,差异无统计学意义(P>0.05),治疗3月后两组便秘临床评分量表、出入后梗阻型便秘评分量表及便秘严重程度量表评分均大幅度降低,差异有统计学意义(P<0.05),组间数据对比差异无统计学意义(P>0.05);试验组手术时间、住院时间、病灶切除宽度与对照组相比更短,术中出血量对比更低,差异有统计学意义(P<0.05);试验组术后并发症发生率较对照组更低,差异有统计学意义(P<0.05),分别为5.26%、21.05%;治疗前两组排粪造影相关指标对比,差异无统计学意义(P>0.05),治疗3月后两组直肠前突程度、直肠内套叠程度、力排相肛直角较治疗前明显降低,差异有统计学意义(P<0.05),会阴下降程度、会阴相肛直角明显上升(P>0.05),组间变化幅度对比,差异无统计学意义(P>0.05)。结论 PPH、STARR在出口梗阻性便秘中的治疗效果相当,但前者术后并发症发生率相对较低,有利于术后康复,建议采纳。Objective To compare and analyze the efficacy of procedure for prolapse and hemorrhoids(PPH)and stapler rectal resection(STARR)in the treatment of outlet obstructive constipation,and to explore the changes in defecography related indicators before and after surgery.Methods A total of 76 patients with outlet obstructive constipation admitted to Anyang People's Hospital from June 2020 to June 2022 were enrolled in this study.A 1∶1 group was divided based on an interval randomized method.The control group received STARR treatment,and the experimental group received PPH treatment.The changes in constipation related scale scores,perioperative related indicators,postoperative complications,and defecography related indicators between the two groups before and after treatment were compared.Results Before treatment,there was no statistically significant difference in the scores of each constipation scale between the two groups(P>0.05).After 3 months of treatment,the scores of the clinical constipation scale,the obstructive constipation scale after entry and exit,and the constipation severity scale in the two groups significantly decreased,with a statistically significant difference(P<0.05).There was no statistically significant difference in data comparison between the groups(P>0.05);The experimental group had shorter operative time,hospital stay,lesion resection width,and lower intraoperative bleeding compared to the control group,with a statistically significant difference(P<0.05);The incidence of postoperative complications in the experimental group was lower than that in the control group,5.26%and 21.05%respectively,with a statistically significant difference(P<0.05);There was no statistically significant difference in defecography related indicators between the two groups before treatment(P>0.05).After 3 months of treatment,the degree of rectal protrusion,the degree of rectal intussusception,and the anal angle of the forced discharge phase in the two groups were significantly lower than before treatment,with a stat

关 键 词：痔上黏膜环切术 吻合器直肠切除术 出口梗阻性便秘 排粪造影 

分 类 号：R657.1[医药卫生—外科学]