吻合器痔上黏膜环切术加直肠前壁柱状缝合治疗中重度直肠前突50例临床观察

Clinical application of the procedure for prolapse and hemorrhoid with hemorrhoid anastomat combined with rectal antetheca styloid suture in treatment of 50 cases of middle and severe degree rectocele

目的探讨应用痔吻合器行痔上黏膜环切术(PPH)加直肠前壁柱状缝合术,治疗因中重度直肠前突伴直肠黏膜内脱垂引起的直肠排空障碍型便秘的临床应用可行性。方法选择50例女性患者,均符合直肠前突伴直肠黏膜内脱垂引起的直肠排空障碍型便秘,其中重度32例,中度18例,均采用该手术方法进行治疗,并对治疗效果进行观察。结果50例患者中治愈35例(70.0%),明显好转12例(24.0%),症状缓解不佳3例(6.0%)。术后均未发生明显的并发症。结论PPH加直肠前壁柱状缝合治疗中重度直肠前突伴直肠黏膜内脱垂引起的直肠排空障碍型便秘疗效显著,并发症少,恢复快,但远期效果有待进一步随访观察。

Objective To investigate the feasibility of clinical application of the procedure for prolapse and hemorrhoids （PPH） with hemorrhoid anastomat combined with rectal antetheca styloid suture to excise slacken rectal mucosa and repair rectocele so as to cure rectal evacuation disorder type constipation caused by middle and severe degree rectocele and rectal internal mucosal prolapse. Methods 50 female patients with rectal evacuation disorder type constipation caused by middle and severe degree rectocele and rectal internal mucosal prolapse were selected in this study, including 32 severe cases and 18 middle degree cases. All the patients were operated by this method, and the therapeutic effect was observed. Results Among 50 patients 35 cases （70.0%） were cured, 12 cases （24.0%） were obviously improved and 3 cases （6.0%） was not improved remarkablely. All the patients had no obvious complica- tions after the operation. Conclusion PPH combined with rectal antetheca styloid suture has remarkable therapeutic effect on rectal evacuation disorder type constipation caused by middle and severe degree rectocele and rectal internal mucosal prolapse, without obvious complications, with quick recovery, but its long-term effect should be followed up and observed further.