發(fā)布時(shí)間：2018-10-29 17:24

【摘要】：目的:探討應(yīng)用直腸黏膜柱狀排列結(jié)扎術(shù)、直腸周圍間隙注射術(shù)聯(lián)合肛門環(huán)縮術(shù)(經(jīng)肛三聯(lián)術(shù))治療重度直腸脫垂的療效及安全性。方法:以2014年3月至2016年3月來(lái)我院肛腸中心就診并接受手術(shù)治療的50例中重度直腸脫垂患者為研究對(duì)象。應(yīng)用隨機(jī)數(shù)字表法,將其隨機(jī)分為治療組和對(duì)照組,每組25例,其中治療組采用三聯(lián)術(shù)治療,對(duì)照組采用肛門環(huán)縮術(shù)聯(lián)合直腸周圍硬化劑注射術(shù)進(jìn)行治療。依據(jù)治愈例數(shù)、排便持續(xù)時(shí)間改善情況、排便頻次改善情況、以及隨訪期肛門墜脹感、肛門脫出情況評(píng)價(jià)兩種術(shù)式的療效,住院天數(shù)、隨訪期直腸脫垂復(fù)發(fā)情況評(píng)價(jià)其安全性。結(jié)果:經(jīng)肛三聯(lián)治療術(shù)(治療組)治愈例數(shù)明顯高于常規(guī)手術(shù)組(對(duì)照組);術(shù)前兩組患者排便持續(xù)時(shí)間、排便頻次均無(wú)顯著差異,經(jīng)過(guò)手術(shù)治療后,兩組患者排便持續(xù)時(shí)間均顯著縮短(均P0.05),其中治療組改善幅度大于對(duì)照組(P0.05),治療組患者排便頻次顯著增加(P0.05),對(duì)照組患者排便頻次變化不明顯(P0.05);治療組術(shù)后直腸脫垂復(fù)發(fā)的概率明顯低于對(duì)照組,在改善患者肛門墜脹感癥狀上明顯優(yōu)于對(duì)照組。治療組患者隨訪期直腸脫垂復(fù)發(fā)例數(shù)明顯低于對(duì)照組(均P0.05),但住院時(shí)間較對(duì)照組延長(zhǎng)。結(jié)論:與常規(guī)手術(shù)治療相比,經(jīng)肛三聯(lián)術(shù)治療重度直腸脫垂療效顯著,預(yù)后良好,安全性高,值得在臨床推廣應(yīng)用。
[Abstract]:Objective: to evaluate the efficacy and safety of rectal mucosal columnar ligation, perirectal space injection and anal ring contraction (transanal triple operation) in the treatment of severe rectal prolapse. Methods: from March 2014 to March 2016, 50 patients with moderate and severe rectal prolapse who had been admitted to our hospital from March 2014 to March 2016 were studied. The patients were randomly divided into the treatment group (n = 25) and the control group (n = 25). The treatment group was treated with triple therapy, and the control group was treated with anal ring contraction combined with perirectal sclerosing agent injection. According to the number of cured cases, the improvement of defecation duration, the improvement of defecation frequency, the feeling of anus fall and distention during the follow-up period, the condition of anal prolapse, the efficacy of the two operations, the days of hospitalization, and the rectum prolapse recurrence during the follow-up period, the safety of the two operations was evaluated. Results: the number of cured cases in the treatment group was significantly higher than that in the conventional operation group (control group). There was no significant difference in defecation duration and defecation frequency between the two groups before operation. After surgical treatment, the defecation duration of the two groups was significantly shortened (P0.05), and the improvement of the treatment group was greater than that of the control group (P0.05). The defecation frequency in the treatment group was significantly increased (P0.05), while the defecation frequency in the control group was not significantly changed (P0.05). The recurrence rate of rectum prolapse in the treatment group was significantly lower than that in the control group, and was superior to that in the control group. The number of rectum prolapse recurrence in the treatment group was significantly lower than that in the control group (P0.05), but the hospitalization time was longer than that in the control group. Conclusion: compared with conventional surgical treatment, transanal triple surgery is effective in the treatment of severe rectal prolapse, with good prognosis and high safety. It is worth popularizing in clinical practice.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R657.1

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