直肠黏膜切除肌层折叠术联合直肠黏膜环切术治疗完全性直肠脱垂患者的效果

Effect of Rectal Mucosal Resection and Myometrial Folding Combined with Procedure for Prolapse and Hemorrhoids in the Treatment of Patients with Complete Rectal Prolapse

目的分析直肠黏膜切除肌层折叠术(Delorme术)联合直肠黏膜环切术(PPH术)治疗完全性直肠脱垂患者的效果。方法选取2017年2月至2019年1月叶县人民医院收治的73例完全性直肠脱垂患者。按照随机数表法分为对照组(36例)和观察组(37例)。对照组患者接受Delorme术治疗,观察组患者接受Delorme术联合PPH术治疗。比较两组疗效、术后30 d临床恢复情况(控便能力、肛门潮湿、肛门坠胀)、并发症,以及术后1、3、7 d疼痛程度,术前及术后2 a肛门直肠压力情况[直肠感觉容量、最大静息压(MRP)、最大收缩压(MSP)]。结果观察组治愈率较对照组高(P<0.05)。术后30 d,观察组控便能力、肛门潮湿、肛门坠胀的评分较对照组低(P<0.05)。观察组并发症发生率较对照组低(P<0.05)。术后3、7 d,观察组疼痛程度均较对照组轻(P<0.05)。术后2 a,两组直肠感觉容量均减少,MRP、MSP均增加,而观察组直肠感觉容量较对照组少,MRP、MSP较对照组大(P<0.05)。结论采用Delorme术联合PPH术治疗完全性直肠脱垂患者的效果显著,可有效促进临床症状恢复,减轻疼痛程度,改善肛门功能,且并发症少。

Objective To analyze the effect of rectal mucosal resection and myometrial folding(Delorme operation)combined with procedure for prolapse and hemorrhoids(PPH operation)in the treatment of patients with complete rectal prolapse.Methods A total of 73 patients with complete rectal prolapse admitted to Yexian People’s Hospital from February 2017 to January 2019 were selected.According to the random number table,they were divided into control group(36 cases)and observation group(37 cases).Patients in control group received Delorme surgery,and patients in observation group received Delorme surgery combined with PPH surgery.The curative effect of the two groups,30 days postoperative clinical recovery(fecal control ability anal dampness anal swelling),complications,postoperative pain degree 1,3,7 days after operation,anorectal pressure before and 2 years condition,including rectal sensory volume,maximum resting pressure(MRP)and maximum systolic blood pressure(MSP).Results The cure rate in observation group was higher than that in control group(P<0.05).Thirty days after surgery,the scores of bowel control ability,anal dampness and anal swelling in observation group were lower than those in control group(P<0.05).The incidence of complications in observation group was lower than that in control group(P<0.05).On the 3rd and 7th day after operation,the pain in observation group was less than that in control group(P<0.05).After 2 years,the rectal sensory volume of the two groups decreased,and MRP and MSP increased(P<0.05).After 2 years,the patients in observation group had less rectal sensory volume than that in control group,and MRP and MSP were larger than those in control group(P<0.05).Conclusion The combination of Delorme surgery and PPH surgery in the treatment of patients with complete rectal prolapse has a significant effect,which could effectively promote the recovery of clinical symptoms,reduce pain,improve anal function,and have fewer complications.