直肠周围间隙硬化剂注射治疗盆底松弛综合征(附32例观察报告)

A STUDY OF TREATMENT FOR RELAXED PELVIC FLOOR SYNDROME BY SCLEROSING AGENT INJEDTION IN PERIRECTUM LACUNA

目的 :评价硬化剂注射术治疗盆底松弛综合征的效果及安全性。方法 :对 32例盆底松弛综合征的病例行硬化剂注射 ,以手术前后排粪造影、肛门测压以及患者排便功能评分结果作自身对比。结果 :直肠内套叠情况与术前比较完全消失 ,差异有显著意义 (P <0 .0 1) ,反映盆底下降的耻尾线肛上距平均缩短了 2 1mm ,差异有显著意义 (P <0 .0 1)。直肠肛门抑制反射 87.5 %恢复正常 (P <0 .0 1) ,肛管最大收缩压 92 .8%恢复正常 (P <0 .0 1)。排便功能评分分别与术前比较 ,术后 1周、 3个月、 6个月 (P <0 .0 1) ,9个月及 12个月 (P <0 .0 5 )差异均有显著意义。无肛周脓肿及腹膜炎发生。结论 :直肠周围间隙硬化剂注射治疗盆底松弛综合征安全、有效 ,作为治疗该类便秘的一种保守治疗方法 。

Objcetive:To assess the effects and security of sclerosing agent injection treatment of relaxed pelvic floor syndrome.Methods: 32 patients with relaxed pelvic floor syndeome were givening ection of sclerosing agent into perirectum lacuna,then the results of the defecography,anorectal dymamics and visual analogue scale (VAS) for defections function of the patients oneself before and afer operation were compared,and the complicating diseases after operation were followed up and recorded.Results:Compared with the previous operatin,the internal rectal intussusception (IRI) disappear completely (P<0 01);the distance between the anorectal junction and the pubococcygeal line that expresses the degree of pelvic floor descends and is shorthened on the average 21 mm (P<0 05);Rectoanal inhibitory reflex reoccured by 87.5% (P<0 01);Anal squeezing pressure recovered by 92.8% P<0 01);visual analogue scale(VAS) was performed at first week,third month,sixth month (P<0 01),9th month and 12th month (P<0 05) respectivcly after the trcatmcnt.All of the statistical analysis showes singnificant diffcrencc.As for thc complication.three patients houve fever below 38℃ after the treatment;30 cases huve some discomfortbl in hypogastrium,sacrum coccyx and per ineum amal or ifice but recoversoon without any administering .Conclution:As a sort of nonopertivetechniquc to treat the constipation caused by relaxed pelvic floor syndrome,sclerosing agent injection is a safe,efficienty and espccially suitable for senile patients that cart be treated by opertion.