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中华结直肠疾病电子杂志 ›› 2017, Vol. 06 ›› Issue (03) : 221 -225. doi: 10.3877/cma.j.issn.2095-3224.2017.03.010

所属专题: 经典病例 文献

论著

PPH联合直肠黏膜套扎治疗直肠前突36例临床观察
吴殿文1,(), 法焕卿1, 张学东1   
  1. 1. 102100 北京市延庆区医院(北京大学第三医院延庆医院)普外科
  • 收稿日期:2017-01-11 出版日期:2017-06-25
  • 通信作者: 吴殿文

The clinical effect of PPH with rectal mucosa ligation for 36 cases with rectocele

Dianwen Wu1,(), Huanqing Fa1, Xuedong Zhang1   

  1. 1. Department of General Surgery, Beijing Yanqing District Hospital (Yanqing Hospital of Peking University Third Hospital) Beijing 102100, China
  • Received:2017-01-11 Published:2017-06-25
  • Corresponding author: Dianwen Wu
  • About author:
    Corresponding author: Wu Dianwen, Email:
引用本文:

吴殿文, 法焕卿, 张学东. PPH联合直肠黏膜套扎治疗直肠前突36例临床观察[J/OL]. 中华结直肠疾病电子杂志, 2017, 06(03): 221-225.

Dianwen Wu, Huanqing Fa, Xuedong Zhang. The clinical effect of PPH with rectal mucosa ligation for 36 cases with rectocele[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2017, 06(03): 221-225.

目的

探讨PPH联合直肠黏膜套扎治疗直肠前突的临床疗效。

方法

选取2012年2月至2014年2月在北京市延庆区医院治疗的中重度直肠前突患者72例,分成2组,对照组行PPH术,观察组行PPH联合直肠黏膜套扎,比较2组的手术时间、术中出血量、住院时间、术后恢复工作时间,术前、术后的Longo-ODS评分,疗效,术前、术后排粪造影直肠前突改善情况及术后复发情况。

结果

2组的手术时间、术中出血量、住院时间、术后恢复工作时间差异均无统计学意义(t=1.342、0.747、0.514、0.751,均P>0.05);2组术前、术后6个月Longo-ODS评分差异无统计学意义(t=-0.884、-0.278,均P>0.05),术后12、24、36个月的Longo-ODS评分观察组明显优于对照组(t=-4.295、-5.832、-8.989,均P<0.05);观察组有效率(91.67%)优于对照组(66.67%),差异有统计学意义(t=6.821,P<0.05);2组术前排粪造影直肠前突深度差异无统计学意义(t=0.475,P>0.05),术后6、12、24、36个月观察组改善情况明显优于对照组(t=-4.968、-7.586、-4.587、-5.414,均P<0.05);2组术后6月均无复发,术后12个月、24个月对照组复发率均高于观察组,但差异无统计学意义(均P>0.05);术后36个月对照组复发率明显高于观察组,差异有统计学意义(P<0.05)。

结论

PPH联合套扎治疗直肠前突,不增加手术时间、出血量、住院时间,不影响恢复时间,具有疗效确切、症状改善明显、复发率低等优点,是直肠前突较好的治疗方式。

Objective

To explore the effect of produce of prolapse and hemorrhiods (PPH) combined with rectal mucosa ligation in the treatment of rectocele.

Methods

Seventy-two serious rectocele patients which were treated in Beijing Yanqing District Hospital from Feb. 2012 to Feb. 2014 were divided into the control group and the observation group. Each group included 36 cases. The former group were treated by PPH and the later group were treated by PPH combined with rectal mucosa ligation. Two groups of operation time, intraoperative blood loss, hospital stay, postoperative recovery time were compared, preoperative and postoperative Longo - ODS score, curative effect were compared. The preoperative and postoperative rectal defecography, the rectocele improvements, the postoperative recurrences of the two groups were also assessed.

Results

The operation time, intraoperative blood loss, hospital stay, postoperative recovery time had no obvious difference between two groups (t=1.3418、0.7467、0.5140、0.7512, P>0.05). The preoperative and 6 month postoperative Longo-ODS score had no statistical significance between two groups (t=-0.8838、-0.2778, P>0.05). 12, 24, and 36 months postoperative Longo-ODS scores of observation group were better than the control group (t=-4.2947、-5.8320、-8.9889, P<0.05). The efficiency (91.67%) of the observation group was obviously better than the control group (66.67%), with statistical significance (t=6.821, P<0.05). The preoperative rectocele depth by defecography in the two groups had no statistical significance (t=0.4754, P>0.05), while 6, 12, 24, 36 months postoperative improvement of the observation group was better than the control group (t=-4.9683、-7.5861、-4.5869、-5.4139, P<0.05). Two groups had no recurrence in 6 month after operation while 12 months and 24 months postoperative recurrence rates of the control group were higher than the observation group, but there was no statistically significant difference (P>0.05). Postoperative 36 months recurrence in the control group was significantly higher than the observation group and the difference was statistically significant (P<0.05).

Conclusions

PPH combined rectal mucosa ligation is a better treatment for rectocele. It does not increase the operation time, blood loss and hospital stay and does not affect the recovery time. It has a definite effect, significant symptoms improvements, and lower recurrence rate.

表1 病人一般情况比较(±s
表2 两组手术情况比较(±s
表3 两组Longo-ODS评分比较(±s
表4 两组患者疗效比较(例,%)
表5 两组直肠前突深度变化比较(mm,±s
表6 两组术后复发率比较(例、%)
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