经肛吻合器直肠黏膜切除术与经直肠闭式修补术治疗直肠前突的临床对比

摘要

目的：比较经肛吻合器直肠黏膜切除术和经直肠闭式修补术对直肠前突的治疗效果。方法选取2013年6月至2014 年6月收治的60例直肠前突患者作为调查对象，随机将其分为对照组和观察组。对照组患者采用经直肠闭式修补术进行治疗，观察组患者采用经肛吻合器直肠黏膜切除术进行治疗。比较两组患者的治疗效果、并发症发生情况以及治疗情况（手术时间、术中出血量、术后疼痛评分、止痛药次数、住院时间、住院费用）。结果治疗后，观察组患者总有效率为93.33%，高于对照组患者总有效率86.67%，但差异无统计学意义（ P ﹥0.05）。治疗后，观察组患者并发症发生率为10.00%，明显低于对照组患者的30.00%（ P ﹤0.05）。且观察组患者手术时间、术中出血量、术后疼痛评分、止痛药需求次数、住院时间均明显低于对照组患者（ P ﹤0.05），但观察组患者住院费用明显高于对照组患者（ P ﹤0.05）。结论经肛吻合器直肠黏膜切除术和经直肠闭式修补术治疗直肠前突，均能起到缓解直肠前突症状的作用，且安全有效。但前者具有疼痛轻、痊愈时间短并发症发生率低等特点，从疗效上看，要优于经直肠闭式修补术。%Objective Using stapled transanal rectal mucosal resection and therapeutic efficacy of transrectal closed repair of rectocele. Methods 60 cases of rectocele were treated and considered as the research object. The patients were randomly divided into control group and ob-servation group. The patients of control group were treated with transrectal closed repair surgery. Patients in the observation group were treated with stapled transanal rectal mucosal resection. The complications of two groups of patients,the effect of treatment,the occurrence and treatment(oper-ation time,bleeding volume,postoperative pain score,analgesic,times of hospitalization time,cost)were compared. Results Two groups of pa-tients after treatment,the total efficiency in observation group was 93. 33% ,which was higher than that of the control group 86. 67% ,but the difference was not statistically significant( P ﹥ 0. 05). After treatment,the incidence rate of the observation group was 10% ,which was signifi-cantly lower than that of the control group( P ﹤ 0. 05). Two groups of patients after treatment,the operation time of stapled transanal rectal muco-sectomy,the amount of hemorrhage,postoperative pain score,analgesic demand times,hospital time were significantly lower than those of the transrectal closed repair treatment of patients in the control group( P ﹤ 0. 05). The observation group patients hospitalization expenses,were sig-nificantly more than those of the patients in the control group( P ﹤ 0. 05). Conclusion Stapled transanal rectal mucosal resection and transrectal closed repair in the treatment of rectocele,can rise to alleviate the symptoms of anterior rectocele effect,which were safe and effective. But the for-mer has the characteristics of less pain,shorter recovery time and lower incidence of complications,according to curative effect,which is better than that of transrectal closed repair.