中华消化病与影像杂志(电子版) ›› 2023, Vol. 13 ›› Issue (06) : 471 -474. doi: 10.3877/cma.j.issn.2095-2015.2023.06.022 × 扫一扫
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Chengpeng Yang, Jia Jin, Mingxiang Wang, Guangyao Dai†()
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杨程鹏, 金佳, 王明祥, 戴光耀. 直肠黏膜环切联合阴道后壁折叠治疗出口梗阻型便秘的效果观察[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 471-474.
Chengpeng Yang, Jia Jin, Mingxiang Wang, Guangyao Dai. Observation on the effect of rectal mucosal circumcision combined with vaginal posterior wall folding in the treatment of obstructive defecation syndrome[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 471-474.
观察直肠黏膜环切联合阴道后壁折叠治疗出口梗阻型便秘(ODS)的效果。
回顾性分析2021年1月至2022年6月石家庄市人民医院收治的75例直肠前突所致ODS女性患者临床资料，根据手术方法将患者分为单纯组(直肠黏膜环切治疗)35例和联合组(直肠黏膜环切联合阴道后壁折叠治疗)30例，对比两组患者治疗效果，包括手术相关指标、直肠前突深度、症状严重度评分(Longo ODS)及术后并发症发生情况及复发率。
联合组手术时间长于单纯组(P<0.05)，术中出血量多于单纯组(P<0.05)，住院时间及创面愈合时间与单纯组比较，差异均无统计学意义(P>0.05)。术后6、12个月，两组直肠前突深度均减小(P<0.05)，联合组直肠前突深度均小于单纯组(P<0.05)；两组Longo ODS评分均降低(P<0.05)，联合组评分均低于单纯组(P<0.05)。联合组并发症发生率与单纯组比较，差异无统计学意义(P>0.05)。联合组的复发率低于单纯组(P<0.05)。
直肠黏膜环切联合阴道后壁折叠治疗ODS效果较好，可以显著改善患者直肠前突形态，调节其排便功能。
To observe the effect of rectal mucosal circumcision combined with vaginal posterior wall folding in the treatment of obstructive defecation syndrome(ODS).
The clinical data of 75 patients with ODS caused by rectocele were retrospectively analyzed.According to their surgical methods, the patients were divided into a simple group of 35 cases and a combined group of 30 cases.The simple group was treated with rectal mucosal circumcision.The combination group was treated with rectal mucosal circumcision combined with vaginal posterior wall folding.The therapeutic effects of the two groups were compared, including surgery-related indicators, rectocele depth, symptom severity score(Longo ODS), postoperative complications, and recurrence rate.
The operation time of the combined group was longer than that of the simple group(P<0.05), the intraoperative blood loss was more than that of the simple group(P<0.05), and the hospital stay and wound healing time were not significantly different from those of the simple group(P>0.05). At 6 month and 12 months after operation, the depth of rectocele in both groups decreased(P<0.05), and the depth of rectocele in the combined group was smaller than that in the simple group(P<0.05). The Longo ODS scores in both groups were decreased(P<0.05), and the Longo ODS score in the combined group were lower than that in the simple group(P<0.05). There was no significant difference in the complication rate between the combined group and the simple group(P>0.05). The recurrence rate of the combined group was lower than that of the simple group(P<0.05).
Rectal mucosal circumcision combined with vaginal posterior wall folding is effective in the treatment of c ODS, which can significantly improve the shape of the rectocele and regulate the defecation function of patients.