内镜下直肠黏膜多点烧灼术治疗直肠内脱垂疗效评价

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。

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

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.