直肠前壁修补联合痔上黏膜环切术治疗女性直肠前突引起的出口梗阻型便秘的临床效果评价

目的:研究直肠前壁修补联合痔上黏膜环切术(PPH)治疗女性直肠前突引起的出口梗阻型便秘的临床价值。方法：将2004?008年在本院诊断并符合手术指征的女性直肠前突患者随机分为单纯直肠前壁修补和直肠前壁修补加PPH两组，分别观察其有效率和Longo’s ODS评分。结果：直肠前壁修补组总有效率为87.71%，直肠前壁修补加PPH组总有效率为97.5%，二者比较差异有显著性（P＜0.01）；直肠前壁修补术组Longo’s ODS评分由术前的17.34±2.77降至6.31±1.31，直肠前壁修补加PPH组Longo’s ODS评分由术前的17.25±2.81降至5.39±1.62，两组患者术后生活质量均有改善，但直肠前壁修补联合PPH效果明显优于单纯直肠前突修补术（P＜0.01）；两组患者均无严重手术并发症。结论：直肠前壁修补联合PPH是治疗女性直肠前突引起的出口梗阻型便秘的安全有效方法，优于单纯直肠前壁修补术。

Clinical evaluation of cotreatment with rectal wall repair and procedure for prolapse and haemorrhoids on outlet obstruction constipation induced by rectocele in woman

Objective To study the clinical value of cotreatment with rectal wall repair and procedure for prolapse and haemorrhoids(PPH)on outlet obstruction constipation(OOC)induced by rectocele in woman.Methods The woman rectocele patients diagnosed and meeting the surgical indications in our hospital from 2004 to 2008 were randomly divided into monotreatment with rectal wall repair group and cotreatment with rectal wall repair and PPH group,and the efficiencies of the procedures and Longo's ODS score were observed.Results The total efficiency in monotreatment with rectal wall repair group was 87.71%,the total efficiency in cotreatment with rectal wall repair and PPH group was 97.5%,there was significant difference between two groups(P<0.01);The Longo's ODS score in monotreatment with rectal wall repair group was decreased from preoperative 17.34±2.77 to postoperative 6.31±1.31,the Longo's ODS score in cotreatment with rectal wall repair and PPH group was decreased from preoperative 17.25±2.81 to postoperative 5.39±1.62.The life qualities were improved significantly in both groups.But the effect of combined treatment with rectal wall repair and PPH in patients with OOC caused by rectocele was more effective than that of monotreatment with rectal wall repair(P<0.01).No major postoperative complications occurred.Conclusion Cotreatment with rectal wall repair and PPH seems to be an effective and safe procedure to treat OOC caused by rectocele;and the procedure is more efficient than monotreatment with rectal wall repair.