选择性吻合器经肛门直肠黏膜部分切除术治疗直肠黏膜脱垂的临床效果  

Clinical effect of selective partial resection of anal and rectal mucosa by stapler in the treatment of rectal mucosal prolapse

作　　者：刘丹璐[1] 冯雪[1] LIU Danlu;FENG Xue(Xi'an Central Hospital,Xi'an 710004,China)

机构地区：[1]西安市中心医院,陕西西安710004

出　　处：《临床医学研究与实践》2024年第35期62-65,共4页Clinical Research and Practice

摘　　要：目的分析选择性吻合器经肛门直肠黏膜部分切除术治疗直肠黏膜脱垂的临床效果。方法纳入我院2020年5月至2022年11月收治的68例直肠黏膜脱垂患者为研究对象,以手术方案差异将其分为常规组(34例,常规双吻合器痔上黏膜环切钉合术)和观察组(34例,选择性吻合器经肛门直肠黏膜部分切除术)。比较两组的治疗效果。结果观察组的手术治疗总有效率显著高于常规组(P<0.05)。观察组的手术时长、创面完全愈合时间短于常规组,术中出血量、吻合口缝合次数少于常规组(P<0.05)。观察组的并发症总发生率显著低于常规组(P<0.05)。术后2 h及3 d、7 d,观察组的视觉模拟评分量表(VAS)评分均显著低于常规组(P<0.05)。术后,观察组的β-内啡肽(β-EP)、神经肽Y(NPY)水平均显著低于常规组(P<0.05)。术后,观察组的肛管最大静息压、肛管最大收缩压均显著低于常规组,直肠最大静息压显著高于常规组(P<0.05)。结论选择性吻合器经肛门直肠黏膜部分切除术治疗直肠黏膜脱垂患者可取得理想的手术效果。Objective To analyze the clinical effect of selective partial resection of anal and rectal mucosa by stapler in the treatment of rectal mucosal prolapse.Methods A total of 68 patients with rectal mucosal prolapse admitted in our hospital from May 2020 to November 2022 were included in the study.The patients were divided into conventional group(34 cases,conventional hemorrhoidal mucosa circumferential nigation by double stapler)and observation group(34 cases,selective partial resection of anal and rectal mucosa by stapler)according to the difference of surgical procedures.The therapeutic effects of the two groups were compared.Results The total effective rate of surgical treatment in the observation group was significantly higher than that in the conventional group(P<0.05).The operation time and complete wound healing time of the observation group were shorter than those of the conventional group,and the intraoperative blood loss and the number of anastomotic sutures were less than those of the conventional group(P<0.05).The total incidence of complications in the observation group was significantly lower than that in the conventional group(P<0.05).At 2 h,3 d and 7 d after operation,the Visual Analogue Scale(VAS)score of the observation group was significantly lower than that of the conventional group(P<0.05).After operation,the levels ofβ-endorphin(β-EP)and neuropeptide Y(NPY)in the observation group were significantly lower than those in the conventional group(P<0.05).After operation,the maximum resting pressure of anal canal and the maximum systolic pressure of anal canal in the observation group were significantly lower than those in the conventional group,and the maximum resting pressure of rectum was significantly higher than that in the conventional group(P<0.05).Conclusion Selective partial resection of anal and rectal mucosa by stapler for patients with rectal mucosal prolapse can achieve ideal surgical results.

关 键 词：直肠黏膜脱垂 常规双吻合器痔上黏膜环切钉合术 选择性吻合器经肛门直肠黏膜部分切除术 

分 类 号：R615[医药卫生—外科学]