PPH术联合围手术期生物反馈及中药熏洗治疗直肠内脱垂

PPH Combined with Biofeedback and Traditional Chinese Medicine Fumigation in Perioperative Period in the Treatment of Intrarectal Prolapse

目的:研究PPH术联合围手术期生物反馈及中药熏洗治疗直肠内脱垂的临床疗效及安全性。方法:选择2019年1—10月到我院进行PPH手术治疗的60例直肠内脱垂患者,按照随机数字表法分为治疗组(30例)和对照组(30例),两组术前均使用生物反馈治疗,术后治疗组予中药熏洗疗法配合生物反馈治疗,而对照组术后未予中药熏洗治疗。观察两组术后7d临床疗效;比较两组术前及术后7d直肠、肛管静息压压力及盆底肌电指数(持续性收缩变异、测试后基线);比较两组患者住院时间及治疗总费用,比较分析术后3d并发症发生情况。结果:治疗组患者术后7d临床总有效率明显高于对照组(P<0.05);治疗组术后7d直肠、肛管静息压压力、持续性收缩变异、测试后基线均低于对照组,比较差异显著(P<0.05);治疗组住院时间与治疗总费用均明显低于对照组,差异具有统计学意义(P<0.05);术后3d,治疗组术后并发症发生率明显低于对照组,比较差异显著(P<0.05)。结论:直肠内脱垂患者PPH术前予生物反馈治疗,术后使用中药熏洗疗法配合,可有效提高临床疗效,改善患者直肠、肛管静息压压力及盆底肌电指数,减少其住院时间与治疗费用,且并发症较少,是一种安全有效的治疗方法,值得临床推广。

Objective:To study the clinical effect and safety of PPH combined with biofeedback and traditional Chinese medicine fumigation in perioperative in the treatment of intrarectal prolapse.Methods:60 patients with intrarectal prolapse who were admitted to our hospital for PPH surgery from January to October 2019 were selected,according to the random number table method,the patients were divided into treatment group(n=30)and control group(n=30),both groups were treated with biofeedback therapy before operation.The treatment group was treated with herbal fumigation therapy for postoperative,while the control group was not treated with herbal fumigation for postoperative.The clinical efficacy of the two groups was observed 7 days after surgery.The rectal and anal static pressure and pelvic floor electromyographic index(continuous systolic variation,post-test baseline)were compared between the two groups before and 7 days after surgery.The length of hospital stay and total cost of treatment were compared between the two groups,and the incidence of postoperative complications was analyzed 3 days after surgery.Results:The total clinical effective ratein the treatment group was significantly higher than that in the control group(P<0.05).Rectal and anal static pressure,continuous systolic variation,and postoperative baseline of the treatment group were all lower than those of the control group 7 days after surgery,with significant difference(P<0.05).Hospitalization time and total cost of treatment in the treatment group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).Postoperatively,the incidence of complications in the treatment group was significantly lower than that in the control group(P<0.05).Conclusion:Patients with intrarectal prolapse were treated with biofeedback therapy before PPH operation,and traditional Chinese medicine fumigation therapy was used after operation,which can effectively improve the clinical curative effect,improve patients with rectum and anal canal resting pressure electric index and pelvic floor muscles,reduce the length of hospital stay and cost of treatment,and less complications,is a safe and effective treatment method,is worthy of clinical promotion.