PPH联合消痔灵注射治疗直肠前突的临床效果观察

Observation of clinical efficacy of PPH combined with Xiaozhiling injection in the treatment of rectocele

目的 通过PPH联合消痔灵注射术和单纯PPH术治疗直肠前突的疗效比较,对比两种手术方式治疗中重度直肠前突的疗效。方法 对我院2004年6月~2010年4月期间治疗的中重度直肠前突的60例患者作为本次的研究对象,并随访3年以上,按照两种术式进行分组,单纯PPH术30例,PPH联合消痔灵注射术30例,对术后有效率、术后并发症进行对比分析。结果 两组患者术后均未使用镇痛泵,A组并发症的发生率（33.37%）与B组（36.67%）比较,无显著差异,均未出现肛门狭窄情况;随着时间的推移,3年A组复发6例（20.00%）,明显高于B组的2例（6.67%）;两组治疗后排便频率、排便感、肛门坠胀、排便时间均明显优于治疗前,差异有统计学意义（P〈0.05）;且B组治疗后排便频率、排便感、肛门坠胀、排便时间明显优于A组,两组差异有统计学意义（P〈0.05）;B组治疗后的总有效率（93.33%）显著优于A组的66.67%,两组差异有统计学意义（P〈0.05）。结论 PPH联合消痔灵注射术在治疗直肠前突中有协同作用,操作简单,治愈率高,值得在基层医院推荐。

Objective To compare the clinical efficacy of PPH combined with Xiaozhiling injection and single PPH in the treatment of medium and severe rectocele by comparing the curive effects of the two surgeries. Methods Sixty pa- tients with medium and severe rectocele who received treatment from June 2004 to April 2010 were selected as the subjects and follow-up for over 3 years. The patients were divided into two groups by the surgeries they received with 30 cases in the single PPH group （group A） and 30 cases in the PPH combined with Xiaozhiling injection group （group B）. The postoperative effects and complications were compared and analyzed. Results Analgesia pumps were not ap- plied on the patients from both groups. The incidence of complications in group A （33.37%） had no significant differ- ences compared with that of group B（36.67%）, and neither of the two groups had stricture of anus; with time passing by, the invalid cases of three years in group A were 6 cases （20.00%）, which was significantly higher than those in group B of 2 cases （6.67%）; after the treatment, patients in two groups had significantly better defecation frequency, defecate feel- ing, straining feeling in anus and defecating time than that of before the treatment and the differences had statistical significance （P〈0.05）; After the treatment, patients in group B had significantly better defecation frequency, defecate feeling, straining felling in anus and defecating time than those in group A and the differences in the two groups had statistical significance （P〈0.05）. Group B had significantly better postoperative total effect （93.33%） than group A （66.67%） and the differences had statistical significance（P〈0.05）. Conclusion PPH combined with Xiaozhiling injection has synergistic effect in the treatment of reeocele with simple operation and higher healing rate, which is worth recommendation in the hospitals in the primary level.