经肛门综合治疗直肠前突26例临床观察

Clinical observation on 26 cases of rectocele treated by combined therapy through anus

目的探索治疗直肠前突引起的出口梗阻型便秘的有效方法。方法采用经肛门直肠下端黏膜吻合器环切、纵行直肠黏膜瓣切除连续缝合术。并针对直肠前突的不同合并症,选择性地进行消痔灵注射、后位耻骨尾骨肌部分切断综合治疗26例。结果术后随访0.5～4年,痊愈21例,显效4例,好转1例,3年复发1例。结论由于显著降低了肛门直肠内压,增大了肛直角,增强了直肠阴道隔抵抗腹内压及肛管张力的能力,切断排便困难—腹压、肛门直肠内压升高—括约肌痉挛性收缩的恶性循环链,从而达到治疗目的,安全有效。

Objective To explore the effective methods for treating outlet obstructive constipation caused by rectoeele. Methods Twenty-six patients with rectocele was treated by mueosal sleeve resection by stapler or rectal mucosal flap longitudinal resection and continuous suture, and XiaoZhiLing injection and posterior pubococcygeal muscle partial section were adopted selectively. Results After a follow-up of half to four years, 21 cases healed completely well, 4 cases had marked effect, 1 case improved and 1 case recurred within three years. Conclusion This combined therapy is safe, reliable and effective for rectocele.