| 摘要: |
| 目的：探讨改良痔上黏膜环切术对出口梗阻型便秘患者肛肠动力学的影响。方法：将 100 例出口梗阻性便秘患者随机分为对照组和治疗组各 50 例，对照组予常规痔上黏膜环切术治疗，治疗组予改良痔上黏膜环切术治疗。观察两组临床疗效、手术一般情况、并发症及复发率，比较肛肠动力学 [ 肛管高压区长度 (HPZ)、静息压 (ARP)、最大收缩压 (MSP)] 的变化。结果：治疗组和对照组术中出血量、创面愈合时间、住院时间、并发症发生率差异无统计学意义（P>0.05），治疗组手术时间明显较对照组延长 [(35.72±3.95) min vs (30.24±3.56) min]（P<0.05）；治疗组和对照组术后 HPZ、ARP、MSP 明显较术前升高，治疗组术后 HPZ[(4.26±0.45) cm vs (3.68±0.38) cm]、ARP[(45.21±4.21) mmHg vs (36.72±3.69) mmHg]、MSP[(130.45±14.27) mmHg vs (116.45±12.82) mmHg] 明显高于对照组（P<0.05）；治疗组有效率 (100% vs 88%) 明显高于对照组（P<0.05）；随访 12 个月，治疗组复发率 (4% vs 8%) 明显低于对照组（P<0.05）。结论：改良 PPH 可有效改善出口梗阻型便秘患者肛肠动力学，有利于提高近远期疗效，且具有良好的安全性。 |
| 关键词: 改良上黏膜环切术 出口梗阻型便秘 肛肠动力学 |
| DOI：10.3969/j.issn.1007-6948.2019.04.037 |
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| 基金项目: |
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| Treatment of 50 Cases of Outlet Obstructive Constipation by Modified Procedure for Prolapse and Hemorrhoids |
| XI Chang-lei,GONG Zhi-lin,ZHOU Qi-chang,YU Jie,YE Hui,CAO Long-lei,WANG Pei-yun |
| Jingzhou Central Hospital, Hubei Province, Jingzhou (434020), China |
| Abstract: |
| Objective To discuss the effect of modified procedure for prolapse and hemorrhoids on the colo-anarectal dynamics in patients with outlet obstructive constipation. Methods One hundred patients with outlet obstructive constipation were selected, according to the random distribution, and all patients were divided into treatment group and control group, 50 cases in each group. The patients in control group were given routine procedure for prolapse and hemorrhoids treatment, the patients in treatment group were given modi?ed procedure for prolapse and hemorrhoids treatment, and the clinical effect, general operation, complications and recurrence rate, and anorectal dynamics [anal high-pressure zone (HPZ), resting pressure (ARP) and peak systolic blood pressure (MSP)] were compared between the two groups. Results The difference was not statistically significant in the intraoperative bleeding, wound healing time, hospitalization time, complication rate of treatment group and control group (P>0.05), the operation time [(35.72±3.95) min vs (30.24±3.56) min] of treatment group was signi?cantly higher than that of control group, and the difference was statistically signi?cant (P<0.05). The postoperative HPZ, ARP and MSP levels of treatment group and control group were signi?cantly higher than those of the preoperative, the postoperative HPZ [( 4 . 26± 0 . 45 ) cm vs ( 3 . 68 ± 0 . 38 ) cm], ARP [( 45. 21± 4 . 21) mmHg vs ( 36. 72± 3 . 69) mmHg] and MSP [( 130. 45± 14. 27) mmHg vs ( 116. 45± 12.82) mmHg] levels of treatment group were signi?cantly higher than those of control group, and the difference was statistically signi?cant (P<0.05). The treatment effective rate (100% vs 88%) of treatment group was signi?cantly higher than that of control group, the difference was statistically significant (P < 0 . 05). During the 12 months of follow-up, the recurrence rate ( 4 % vs 8 %) of treatment group was significantly lower than that of control group, and the difference was statistically signi?cant (P <0.05). Conclusions Modified procedure for prolapse and hemorrhoids can effectively improve the anorectal dynamics in patients with outlet obstructive constipation, which is bene?cial to the improvement of the patient' s near and long term effect, and it has good safety, it is worth for further clinical promotion. |
| Key words: Modified procedure for prolapse and hemorrhoids outlet obstructive constipation colo-anarectal dynamics |
