吻合器经肛直肠切除术联合耻骨直肠肌挂线术治疗出口梗阻型便秘的临床疗效

Clinical efficacy of stapled transanal rectal resection combined with thread-drawing of puborectal muscle in the treatment of outlet obstructive constipation

目的探讨吻合器经肛直肠切除术(STARR)联合耻骨直肠肌挂线术治疗出口梗阻型便秘的疗效。方法选择2018年9月至2020年3月湖南中医药大学第二附属医院痔瘘便秘专科住院部收治的出口梗阻型便秘患者68例,采用STARR联合耻骨直肠肌挂线术进行治疗。比较治疗前后的Wexner评分、排便时间及肛门直肠测压。结果患者术后Wexner评分较术前明显减小、排便时间缩短;肛门直肠测压显示,肛管静息压、肛管最大收缩压、肛管舒张压均有不同程度的改善,差异有统计学意义(P<0.05)。结论STARR联合耻骨直肠肌挂线术治疗出口梗阻型便秘治疗效果显著,值得推广。

Objective To explore the effect of stapled transanal rectal resection(STARR)combined with thread-drawing of puborectal muscle in the treatment of outlet obstructive constipation.Methods A total of 68 patients with outlet obstructive constipation who were admitted to the hemorrhoid and constipation specialist department of the Second Affiliated Hospital of Hunan University of Chinese Medicine from September 2018 to March 2020 were selected and treated with STARR combined with puborectal muscle thread-drawing.The Wexner score,defecation time and anorectal pressure measurement before and after treatment were compared.Results The Wexner score of the patient was significantly reduced after the operation compared with that before the operation,the defecation time was shorter than that before surgery;anorectal pressure measurement showed that the resting pressure,the maximum systolic pressure,and the diastolic pressure of the anal canal all improved to varying degrees,the differences were statistically significant(P<0.05).Conclusion STARR combined with thread-drawing of puborectal muscle has a significant effect in the treatment of outlet obstructive constipation,and it is worthy of promotion.