STARR术联合耻骨直肠肌松解术治疗女性出口梗阻型便秘的临床研究

目的探讨在治疗女性出口梗阻型便秘的过程中应用SARR术联合耻骨直肠肌松解术的应用效果。方法回顾性研究我科2017年8月～2018年10月期间手术治疗的245例女性直肠前突患者,按照所行手术方式将患者分为甲组:行单纯STARR术、乙组:行直肠黏膜套扎术、丙组:行STARR术联合耻骨直肠肌松解术。术后15 d对比甲、乙、丙三组患者手术前后直肠前突程度;术后2个月、半年、一年随访时对比排便时间、排便不尽感、肛门坠胀程度的评分;对比三组疗效。结果甲、乙、丙三组患者术后15 d直肠前突程度均较术前有明显改善,有统计学意义(P0.05),其中甲组和乙组的改善程度无明显差异(P0.05),但丙组的改善程度明显优于甲、乙组,差异有统计学意义(P0.05);对于术后2个月、半年、一年随访时排便时间、排便不尽感、肛门坠胀程度评分比较发现:三组手术方式对于女性直肠前突患者的排便时间、肛门坠胀感及排便不尽感均有一定的改善作用,丙组在一年后症状改善上要优于甲、乙两组(P0.05),在疗效方面丙组明显优于甲、乙两组,差异有统计学意义(P0.05)。结论 STARR术联合耻骨直肠肌松解术对治疗女性出口梗阻型便秘在症状改善及疗效方面有令人更满意的结果。

Clinical study of STARR combined with pubic rectum muscle of drug release in treatment of female outlet obstructive constipation

Objective To explore the application of stapled transanal rectal resection(STARR) combined with pubic rectum muscle of drug release in treatment of female outlet obstructive constipation.Methods 245 female rectocele patients treated in our department from August 2017 to October 2018 were retrospectively analyzed.The patients were divided into group A,B and C according to the surgical method.Group A was given STARR alone,group B was given rectal mucosal ligation and group C was given STARR combined with pubic rectum muscle of drug release.15 days after operation,the degree of rectal protrusion before and after surgery was compared between groups A,B,and C.The defecation time,the feeling of endless defecation,and the degree of anal swelling at two months,six months,and one year after operation were compared.The efficacy of the three groups was compared.Results The degree of rectal protrusion of patients in group A,B,and C at 15 days after surgery was significantly improved as compared with that before surgery,and the difference was statistically significant (P<0.05),while there was no significant difference in the im provement between group A and group B (P>0.05),but the improvement degree of group C was significantly better than that of group A and group B,and the difference was statistically significant (P<0.05).At the same time,the defecation time,feeling of endless defecation and the degree of anal swelling were followed up at 2 months,half a year,and one year after surgery and the results showed that the above three index in the three groups improved to a certain extent,and group C was better in symptoms improvement after one year of surgery than group A and group B (P<0.05).The effect of group C was significantly better than that in group A and group B,and the difference was statistically significant (P<0.05).Conclusion STARR combined with pubic rectum muscle of drug release can improve symptoms and efficacy in the treatment of female outlet obstructive constipation,and has a more satisfactory outcome.