直肠黏膜剥除肌层折叠术联合直肠黏膜环切术治疗完全性直肠脱垂的疗效分析

Therapeutic effect of Delorme combined with PPH in treating complete rectal prolapse

目的探讨直肠黏膜剥除肌层折叠术(Delorme)+直肠黏膜环切术(PPH)对完全性直肠脱垂患者治疗的疗效分析。方法回顾性分析2015年1月至2017年1月直肠脱垂患者60例资料,根据手术方式分为行Delorme术+PPH术的患者为研究组,仅行Delorme术的患者为对照组,各30例。使用SPSS20. 0统计软件分析,术后30 d排便情况、肛门潮湿及坠涨评分比较采用均数±标准差表示,组间采用独立t检验;手术治愈率、术后疼痛比较采用χ2检验。以P <0. 05差异有统计学意义。结果术后研究组患者治愈率100%显著高于对照组83. 3%(P <0. 05);研究组患者在术后3 d、7 d疼痛度显著低于对照组(P <0. 05);术后30 d,研究组患者控便能力、排便次数及时间、术后肛门潮湿度及坠涨情况评分、术后不良反应等均显著优于对照组,差异有统计学意义(P <0. 05)。结论 Delorme术联合PPH治疗完全性直肠脱垂较患者,疗效更为确切,显著提高患者手术治愈率,增强术后患者的排便能力,降低患者疼痛度,有效减少并发症及不良反应。

Objective To investigate the effect of Delorme(rectal mucosa stripping)+PPH(rectal mucosal loop)operation for patients with complete rectal prolapse. Methods Retrospective analysis were performed in 60 cases of rectal prolapse patients from January 2015 to January 2017,according to the surgical method was divided into Delorme+PPH study group(30 cases)and Delonme control group(30 cases).Clinical data were analyzed by using statistical software SPSS 20.0.Measurement data such as Postoperative 30 d defecation condition,anus dampness and fall score were expressed as mean±standard deviation,and independent t test was used for comparison between the groups.Count data,such as curative rate and postoperative pain rate were expressed as%,and were examined by usingχ2 test.A P value<0.05 was considered as statistically significant difference.The curative rate of the study group was 100%,which was significantly higher than that of the control group(83.3%)(P<0.05).The pain level of POD 3d and POD 7d in the study group was significantly lower than those in the control group respectively(P<0.05).POD 30 d,the patient’s ability to control stool,the number of defecation,the time of defecation,the humidity and fall of the anus,and postoperative complications in the study group were all significantly better than those in the control group,with significant difference(P<0.05). Conclusion Delorme combined with PPH in the treatment of complete rectal prolapse was more effective for patients with complete rectal prolapse.It could significantly improve the curative rate,enhance the defecation ability,and reduce pain of patients,with less complications and adverse reactions.