桥式修补联合手术治疗阴道后壁膨出对患者肛功能及复发的改善

Improvement of patients' norectal function and recurrence by bridge repair combined operation in treatment of douglascele

目的探讨桥式修补联合手术对阴道后壁膨出患者肛功能及复发的改善作用。方法选取2013年4月至2014年6月我院收治的阴道后壁膨出患者66例为研究对象,随机分为观察组和对照组各33例,对照组采取传统阴道后壁膨出修补术,观察组采取阴道旁修补术联合自体组织桥式修补术,比较两组围术期指标、肛功能,并采用尿失禁生活质量问卷表(I-QOL)分析预后情况,记录并发症与复发率。结果两组手术时间、住院时间、术中出血量比较无显著差异(P>0.05);治疗后观察组直肠力排压(15.27±1.56)mmHg、肛管松弛率(5.79±2.08)%低于对照组(P<0.05),观察组肛管力排剩余压(55.46±1.32)mmHg、I-QOL评分(89.47±2.54)分较对照组高(P<0.05);观察组1年内复发率6.1%低于对照组18.2%(P<0.05),两组并发症发生率3.0%、6.1%比较无显著差异(P>0.05)。结论桥式修补联合手术可有效改善阴道后壁膨出患者肛功能、生活质量,复发率低,值得在临床推广应用。

Objective To explore improvement of patients＇ norectal function and recurrence by bridge repair combined operation in treatment of douglascele.Methods 66 patients with douglascele treated in our hospital from April 2013 to June 2014 were selected as the research objects, they were divided into the observation group and the control group randomly （each 33 cases）, the control group took traditional douglascele neoplasty, the observation group took paravaginal repair combined with autologous tissue bridge repair, perioperative indexes and anorectal function in the two groups were compared, incontinence quality-of-life questionnaire （I-QOL） was used to analyze prognosis, complications and recurrence rate were recorded.Results There was no significant difference in operation time, length of stay and intraoperative blood loss between the two groups （P〉0.05）; rectal pressure （15.27±1.56）mmHg, anal canal relaxation rate （5.79±2.08）% in the observation group after the treatment were significantly lower than the control group （P〈0.05）, anal tube exhaust residual pressure （55.46±1.32）mmHg, I- QOL score （89.47±2.54）scores in the observation group were significantly higher than the control group （P〈 0.05）; recurrence rate in 1 year in the observation group 6.1% was significantly lower than the control group （18.2%） （P〈0.05）, there was no significant difference in complication rate between the two groups （3.0%, 6.1%） （P〉0.05）. Conclusion Bridge repair combined operation can effectively improve anorectal function and quality of life of patients with douglascele with low recurrence rate, has a value of clinic application.