痔上黏膜环切术与经肛吻合器直肠切除术治疗梗阻型便秘

Clinical Effects of PPH and STARR on the Treatment Obstruction Constipation

目的：探讨痔上黏膜环切术（Procedure for Prolapse and Hemorrhoids，PPH）及经肛吻合器直肠切除术（Stapled Trans-anal Rectal Resection，STARR）治疗出口梗阻型便秘的临床疗效。方法：选择2012年5月-2014年5月在我院接受治疗的梗阻型便秘患者100例，随机分为PPH组和STARR组，每组各50例，分别予PPH术和STARR术治疗。观察并比较两组患者治疗前后Longo出口梗阻型便秘评分及Wexner便秘严重程度评分。结果：两组患者术中出血量比较，差异无统计学意义（P〉0．05）：PPH组患者手术时间、住院时间及治疗费用明显少于STARR组，差异有统计学意义（P〈0．05）。两组患者术后并发痘的发生率无显著差异，无统计学意义（P〉0．05）。两组患者术前Longo评分及Wexner评分比较，差异无统计学意义（P〉0．05）；术后STARR组评分低于PPH组，差异有统计学意义（P〈0．05）。结论：与经肛吻合器直肠切除术相比，痔上黏膜环切术操作简单，更易被患者接受，值得临床推广应用。

Objective： To investigate the hemorrhoid on mucosal fibrotomy （Procedure for Prolapse and Hemorrhoids, PPH） and the anus stapling rectum Resection （Stapled Trans-anal Rectal Resection, STARR） clinical curative effect for the treatment of type outlet obstruction constipation. Methods： 100 cases with constipation who were treated in our hospital from May 2012 to May 2014 were selected and randomly divided into PPH group and STARR group with 50 cases in each group, respectively, for the treatment of PPH and STARR. To observe and compare the two groups before and after treatment in patients with type Longo outlet obstruction constipation score and Wexner constipation severity score. Results： two groups of patients with intraoperative blood loss, there was no statistically significant difference （P〉0.05）; PPH group, operation time, length of hospital stay and cost of treatment in patients with significantly less than STARR＇group, the difference was statistically significant （P〈0.05）. Two groups of patients, there was no difference in the incidence of complications, no statistical significance （P〉0.05）. Two groups of patients with preoperative Longo grade and Wexner comparison, there was no statistically significant difference （P〉0.05）; Postoperative STARR score lower than that of PPH group, the difference was statistically significant （P〈0.05）. Conclusion： Compared with the anus stapling rectum resection, hemorrhoids mucosa fibrotomy operation simple, easier accepted by patients, worthy of clinical popularization and application.