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中华消化病与影像杂志(电子版)

中华消化病与影像杂志(电子版) ›› 2021, Vol. 11 ›› Issue (02) : 67 -71. doi: 10.3877/cma.j.issn.2095-2015.2021.02.005

所属专题： 文献；

临床研究

内镜下直肠黏膜多点烧灼术治疗直肠内脱垂疗效评价
李军1, 王彬1, 刘绘1, 杨冬梅1, 孔凡鹏1, 裴昭晗1, 张亚利2, 石娜3,†(), 袁海鹏2   
  1. 1. 271500　山东泰安，东平县人民医院肛肠科
    2. 271000　山东泰安，泰安市中心医院肝胆胰腺内科
    3. 271000　山东泰安，泰安市中心医院中心实验室
  • 收稿日期:2020-05-09 出版日期:2021-04-01
  • 通信作者: 石娜

Efficacy evaluation of endoscopic multi-point cauterization of rectal mucosa on internal rectal prolapse

Jun Li1, Bin Wang1, Hui Liu1, Dongmei Yang1, Fanpeng Kong1, Zhaohan Pei1, Yali Zhang2, Na Shi3,†(), Haipeng Yuan2   

  1. 1. Department of Proctology, Dongping County People's Hospital, Tai'an 271500, China
    2. Department of Hepatobiliary and Pancreatic Medicine, Tai'an Central Hospital, Tai'an 271000, China
    3. Central Laboratory, Tai'an Central Hospital, Tai'an 271000, China
  • Received:2020-05-09 Published:2021-04-01
  • Corresponding author: Na Shi
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引用本文：

李军, 王彬, 刘绘, 杨冬梅, 孔凡鹏, 裴昭晗, 张亚利, 石娜, 袁海鹏. 内镜下直肠黏膜多点烧灼术治疗直肠内脱垂疗效评价[J]. 中华消化病与影像杂志(电子版), 2021, 11(02): 67-71.

Jun Li, Bin Wang, Hui Liu, Dongmei Yang, Fanpeng Kong, Zhaohan Pei, Yali Zhang, Na Shi, Haipeng Yuan. Efficacy evaluation of endoscopic multi-point cauterization of rectal mucosa on internal rectal prolapse[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2021, 11(02): 67-71.

目的

与直肠黏膜纵行折叠加硬化剂注射术对比，评价内镜下直肠黏膜多点烧灼术治疗直肠内脱垂的疗效。

方法

前瞻性选取2013年8月至2018年10月东平县人民医院收治的直肠内脱垂患者80例。随机均分为对照组与治疗组2组，每组各40例。对照组患者采用直肠黏膜纵行折叠加硬化剂注射术治疗，治疗组患者采用内镜下直肠黏膜多点烧灼术治疗。对照组2例患者失访，最终38例患者纳入本研究。比较术前及术后3、6、12、18个月两组患者便秘症状评分。

结果

术前、术后3个月两组患者便秘症状评分差异均无统计学意义；治疗组患者术后6、12、18个月便秘症状评分均低于对照组患者[（2.0±0.2）分vs （2.2±0.3）分，（1.5±0.1）分vs （1.9±0.2）分，（0.7±0.1）分vs （1.7±0.1）分]，且差异均有统计学意义（t=4.773、11.841、48.474，P均<0.001）。

结论

内镜下直肠黏膜多点烧灼术治疗直肠内脱垂操作简便，临床症状明显改善，长期疗效远优于直肠黏膜纵行折叠加硬化剂注射术。

关键词: 直肠内脱垂, 直肠黏膜多点烧灼术, 直肠黏膜纵行折叠, 硬化剂注射术, 便秘症状评分
Objective

To evaluated the efficacy of endoscopic multi-point cauterization of rectal mucosa in the treatment of internal rectal prolapse compared with longitudinal folding plus sclerosant injection.

Methods

A total of 78 patients with internal rectal prolapse treated in Dongping County People's Hospital from August 2013 to October 2018 were prospectively selected as the research objects. All patients were randomly divided into control group and treatment group, with 40 patients in each group. The control group was treated by longitudinal folding plus sclerosant injection, while the treatment group was treated by multi-point cauterization of rectal mucosa under endoscope. Two patients in the control group were lost to follow-up, and 38 patients were finally included in this study. The constipation symptom scores of the two groups before operation and 3, 6, 12, 18 months after operation were compared.

Results

There was no statistically significant difference in the scores of constipation symptoms between the two groups before and 3 months after operation. The scores of constipation symptoms at 6, 12 and 18 months after operation in the treatment group were all lower than those in the control group (2.0±0.2 vs. 2.2±0.3, 1.5±0.1 vs. 1.9±0.2, 0.7±0.1 vs. 1.7±0.1), and there were statistically significant differences (t=4.773, 11.841, 48.474, all P<0.001).

Conclusion

Endoscopic rectal mucosal multi-point cauterization for the treatment of internal rectal prolapse is easy to operate, the clinical symptoms are significantly improved, and the long-term curative effect is far better than rectal mucosal longitudinal folding plus sclerosant injection.

Key words: Internal rectal prolapse, Rectal mucosa multi-point cauterization, Rectal mucosa longitudinal folding, Sclerosant injection, Constipation score
表1 便秘症状评分标准
观察指标 0分 2分 4分 6分
排便费力 无 偶尔 经常 总是
会阴部不适 无 偶尔 经常 总是
排便不尽感 无 ≤1次/月 2~6次/月 >6次/月
排便次数/d 1次 2次 3次 ≥4次
排便持续时间 <5 min 6~10 min 11~20 min >20 min
药物通便 无 ≤4次/月 5~10次/月 >10次/月
手助通便 无 ≤1次/月 2~6次/月 >6次/月
表2 两组患者一般临床资料比较
组别 例数 年龄（岁，±s） 性别（例，男性/女性）
治疗组 40 61.0±5.5 13/27
对照组 38 60.0±5.3 11/27
统计值   t=-0.817 χ2=0.115
P值   0.417 0.734
表3 手术前后两组患者便秘症状评分比较（分，±s）
组别 例数 术前 术后3个月 术后6个月 术后12个月 术后18个月
治疗组 40 25.4±2.4 2.5±0.2 2.0±0.2 1.5±0.1 0.7±0.1
对照组 38 24.9±2.1 2.5±0.3 2.2±0.3 1.9±0.2 1.7±0.1
t值   -1.140 1.124 4.773 11.841 48.474
P值   0.258 0.265 <0.001 <0.001 <0.001
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