改良四面二次注射加直肠纵行缝扎治疗直肠黏膜内脱垂的临床效果评价

Effect of modified repeated four-area ligation combined with longitudinal suture for treating internal rectal prolapse

目的评价改良四面二次注射加直肠纵行缝扎治疗直肠黏膜内脱垂的临床疗效。方法纳入2018年9月至2019月9月重庆市中医院肛肠科收治的127例直肠黏膜内脱垂患者为研究对象,采用随机数字表法将患者随机分为治疗组(采用改良四面二次注射加直肠纵行缝扎治疗)和对照组(采用四面二次注射加直肠纵行缝扎治疗)。剔除脱落患者6例,最后共观察有效病例121例,其中治疗组69例,对照组52例。观察记录两组手术时间、排粪症状、粪便性状并进行安全性评价。结果治疗组手术时间为(37.7±6.6)min,对照组为(32.6±8.3)min,组间比较差异无统计学意义(P>0.05)。两组术前及术后3个月的排粪症状评分比较差异均无统计学意义(均P>0.05);术后14天,治疗组的排粪症状评分较对照组低,差异有统计学意义(P<0.05);两组术后14天及术后3个月的排粪症状评分均较术前低,差异有统计学意义(均P<0.05)。治疗前及治疗后3个月,两组粪便性状Bristol分级情况比较差异均无统计学意义(均P>0.05)。两组治疗安全性比较差异无统计学意义(P>0.05)。结论改良四面二次注射加直肠纵行缝扎治疗IRP安全有效,且手术方式简捷。

Objectives To investigate the effect of modified repeated four-area ligation combined with longitudinal suture for treating internal rectal prolapse.Methods One hundred and twenty-seven patients with internal rectal prolapse treated at the De⁃partment of Anorectal Diseases,Chongqing Traditional Chinese Medicine Hospital,between September 2018 and September 2019 were recruited.Patients were randomly assigned to the treatment group(receiving modified repeated four-area ligation combined with longitudinal suture)and control group(receiving repeated four-area ligation combine with longitudinal suture).Six patients had an abruption.The final analysis included 121 patients,including 69 in the treatment group and 52 in the control group.The surgery duration,symptom scores for bowel movement,Bristol stool scale,and safety were compared between the two groups.Results The surgery duration was(37.7±6.6)min in the treatment group and(32.6±8.3)min in the control group,with no signif⁃icant difference between the two groups(P>0.05).Symptom scores for bowel movement before surgery and 3 months after surgery did not differ between the two groups(P>0.05),but symptom scores at 14 days after surgery was significantly lower in the treat⁃ment group(P<0.05).In both groups,symptom scores decreased significantly at 14 days and 3 months after surgery(P<0.05).Be⁃fore surgery and 3 months after surgery,Bristol stool scales did not differ between the two groups(P>0.05).Safety of procedure was similar between the two groups(P>0.05).Conclusion Modified repeated four-area ligation combined with longitudinal suture is a simple procedure and is effective and safe for treating internal rectal prolapse.