吻合器直肠黏膜环切术治疗直肠前突的临床研究

The Clinical Research of Stapled Rectal Mucosa Cerclage Operation on treating Rectocele

目的观察和评价吻合器直肠黏膜环切术治疗直肠前突所致出口梗阻型便秘的临床疗效。方法将100例经排粪造影检查证实直肠前突深度≥30mm的患者随机分为观察组和对照组,其中观察组50例,采用吻合器直肠黏膜环切术;对照组50例,采用经直肠切开前突修补术。比较观察两组患者的手术用时、术中出血量情况,并根据疗效评分标准进行评价。结果两组临床疗效比较,观察组明显优于对照组(P<0.05);两组手术时间比较,差异无统计学意义(P>0.05);两组术中出血量比较,观察组明显优于对照组(P<0.05)。两组均无直肠阴道瘘、直肠周围感染、直肠狭窄等并发症发生。结论吻合器直肠黏膜环切术治疗直肠前突操作简单、安全,具有疗效好、微创、并发症少等优点,值得临床推广。

Objective To observe and evaluate the clinical efficacy of stapled rectal mucosa cerclage on treating outlet obstructive constipation due to rectocele.Methods One hundred patients who were confirmed rectocele more than 30mm through defecography were randomly divided into the treatment group and the control group.Fifty patients in the treatment group were given the stapled rectal mucosa cerclage, and 50 patients in the control group were given the transrectal incision rectocele repair operation.The operation time and the amount of bleeding in operation condition of the two groups were compared,observed and evaluated according to the effect of grading standard.Results In the respect of clinical effect,the stapled rectal mucosa cerclage is obviously better than the transrectal incision rectocele repair operation （P〈0.05）.There was no statistically significant difference when comparing operation time between two groups （P〉0.05）.The stapled rectal mucosa cerclage in the respect of hemorrhagic in operation has remarkable effect comparing the transrectal incision rectocele repair operation （P〈0.05 ）.No rectovaginal fistula, perirectal infections and proctostenosis-related complication was occurred in both groups.Conclusion The stapled rectal mucosa cerclage in treating rectocele is simple and safe.Being less invasive and less complications,it has a advantage of good curative effect and it’s worthy of clinical application.