经肛三联术治疗中重度直肠脱垂的疗效及安全性研究

发布时间：2018-10-29 17:24

【摘要】：目的:探讨应用直肠黏膜柱状排列结扎术、直肠周围间隙注射术联合肛门环缩术(经肛三联术)治疗重度直肠脱垂的疗效及安全性。方法:以2014年3月至2016年3月来我院肛肠中心就诊并接受手术治疗的50例中重度直肠脱垂患者为研究对象。应用随机数字表法,将其随机分为治疗组和对照组,每组25例,其中治疗组采用三联术治疗,对照组采用肛门环缩术联合直肠周围硬化剂注射术进行治疗。依据治愈例数、排便持续时间改善情况、排便频次改善情况、以及随访期肛门坠胀感、肛门脱出情况评价两种术式的疗效,住院天数、随访期直肠脱垂复发情况评价其安全性。结果:经肛三联治疗术(治疗组)治愈例数明显高于常规手术组(对照组);术前两组患者排便持续时间、排便频次均无显著差异,经过手术治疗后,两组患者排便持续时间均显著缩短(均P0.05),其中治疗组改善幅度大于对照组(P0.05),治疗组患者排便频次显著增加(P0.05),对照组患者排便频次变化不明显(P0.05);治疗组术后直肠脱垂复发的概率明显低于对照组,在改善患者肛门坠胀感症状上明显优于对照组。治疗组患者随访期直肠脱垂复发例数明显低于对照组(均P0.05),但住院时间较对照组延长。结论:与常规手术治疗相比,经肛三联术治疗重度直肠脱垂疗效显著,预后良好,安全性高,值得在临床推广应用。
[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.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.1

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