芍倍注射液注射加黏膜多点结扎肛门环缩术治疗直肠脱垂的临床探讨

Clinical Study on Treatment of Rectal Prolapse with Injection of Sputum Injection and Multi-point Ligation of Anus

目的探讨芍倍注射液黏膜下注射加黏膜多点结扎固定肛门环缩术治疗Ⅱ、Ⅲ度直肠脱垂的临床疗效。方法方便选取2010年4月—2018年4月该院肛肠科收治的Ⅱ、Ⅲ度直肠脱垂患者74例,随机分为观察组和对照组,观察组38例予以芍倍注射液黏膜下注射加黏膜多点结扎固定肛门环缩术,对照组36例选择Delorme手术治疗,术后2年随访。观察两组住院一般情况,术后早期并发症,临床疗效及复发情况。结果两组痊愈率(100.00%vs 91.67%(Z=1.78,P=0.071)及复发率0.00%vs 2.78%(Z=-1.00,P=0.35),差异无统计学意义(P>0.05),观察组手术时间[(44.52±4.88)min vs(76.97±4.65)min(t=-29.23,P<0.000)]、住院时间[(6.97±1.03)d vs(14.38±1.87)d(t=-21.3,P<0.000)]、住院费用[(12082±948.32)元vs(18143±688.39)元(t=-31.31,P<0.000)]均显著低于对照组,差异有统计学意义(P<0.05),观察组术后感染(χ^2=4.25,P=0.039)、出血(χ^2=5.66,P=0.017)、便秘(χ^2=4.46,P=0.034)发生率显著低于对照组,差异有统计学意义(P<0.05)。结论芍倍注射液黏膜下注射加黏膜多点结扎固定肛门环缩术治疗Ⅱ、Ⅲ度直肠脱垂疗效确切,术后并发症少,费用低,且操作简便。适合临床推广。

Objective To investigate the clinical efficacy of subcutaneous mucosal injection plus mucosal multi-point ligation and anal circumflex for the treatment of Ⅱ and Ⅲ rectal prolapse. Methods From April 2010 to April 2018, 74 patients with grade Ⅱ and Ⅲ rectal prolapse treated in the anorectal department of the hospital were convenient selected and randomly divided into observation group and control group. 38 patients in the observation group were given submucosal injection plus mucous membrane. Multiple points of ligation were used to fix the anal ring contraction. 36 patients in the control group were treated with Delorme surgery and followed up for 2 years. The general conditions of hospitalization, early postoperative complications, clinical efficacy and recurrence were observed. Results There were no significant differences in the cure rate 100.00% vs 91.67%(Z=1.78, P=0.071) and recurrence rate(0.00% vs 2.78%)(Z=-1.00, P=0.35) between the two groups,the difference was statistically significant(P>0.05). The operation time of the observation group [(44.52±4.88) min vs(76.97±4.65) min(t=-29.23, P<0.000)], hospitalization time [(6.97±1.03)d vs(14.38±1.87)d(t=-21.3, P<0.000)], hospitalization expenses [(12 082±948.32) yuan vs(18 143±688.39) yuan(t=-31.31, P<0.000)] were significantly lower than the control group, the difference was statistical Academic significance(P<0.05), the postoperative infection(χ^2=4.25, P=0.039),hemorrhage(χ^2=5.66, P=0.017), constipation incidence(χ^2=4.46, P=0.034) was statistically significantly lower than that of the control group,the difference was statistically significant(P<0.05). Conclusion The submucosal injection plus mucosal multi-point ligation and anal circumflex for the treatment of Ⅱ and Ⅲ rectal prolapse is effective, with less postoperative complications, low cost and easy operation, suitable for clinical promotion.