PPH治疗出口梗阻型便秘50例疗效观察

Observation on the Therapeutic Efficacy of PPH in the Treatment of Outlet Obstructive Constipation：Analysis of 50 Cases

为探讨吻合器痔上黏膜环切术（PPH）治疗出口梗阻型便秘的疗效，对50例出口梗阻型便秘患者行PPH治疗。50例患者均合并中、重度痔，除痔外，单纯合并直肠黏膜内脱垂27例，合并中、重度直肠前突加直肠黏膜内脱垂18例，合并耻骨直肠肌综合征并直肠黏膜内脱垂5例。结果显示，本组治愈42例。好转5例，无效3例，有效率为94．0％。无效的3例均为重度卣肠黏膜内脱垂合并耻骨直肠肌肥厚者。结果表明，PPH治疗以直肠前突和直肠黏膜内脱垂为主的出口梗阻型便秘疗效显著，但对耻骨直肠肌综合征引起的出口梗阻型便秘单纯行PPH矫治疗效欠佳。

In order to investigate the therapeutic effect of PPH on outlet obstructive constipation（OOC）, authors analysed the date from fifty patients with OOC who underwent PPH. In the 50 patients with OOC, all had concurrent moderate or severe hemorrhoids; also, concurrent internal prolapse of rectal mucosa （IPRM） was seen in 27 cases,concurrent IPRM plus moderate and severe rectocele in 18 cases and concurrent IPRM plus syndrome of puborectal muscle in 5 cases. As results, cure was achieved in 42 cases,im provement in 5 cases and no improvement was obtained in 3 cases. The general effective rate was 94.0% ; No improvement was obtained in the 3 patients who had concurrent severe IPRM and puborectal muscle pachismus. It is concluded that PPH can bring about obvious therapeutic effect to patients with OOC accompanied by rectoeele and/or IPRM, but poor therapeutic result to patients with OOC accompanied with syndrome of puborectal muscle.