提肛运动改善重度痔吻合器痔上黏膜环切术后肛门坠胀的研究

目的探讨提肛运动改善重度痔行吻合器痔上黏膜环切术（PPH）后肛门坠胀的疗效。方法选取2010年10月-2012年12月在右江民族医学院附属医院肛肠科行PPH术±痔外剥内扎术且术后出现肛门坠胀的患者150例，随机分为提肛组及对照组，每组各75例。提肛组术后第3日起即每日进行提肛运动的功能锻炼；对照组75例常规治疗护理。对比观察两组术后肛门坠胀积分、急便感和控便能力。结果①治疗后两组坠胀时间积分【（0．36±0．08）、（1．16±0．91）分】、坠胀程度积分【（0．30±0．07）、（0．93±0．57）分】均较治疗前显著下降，差异均有高度统计学意义（P〈0．01）；且治疗后提肛组坠胀时间积分、坠胀程度积分均低于对照组，差异有高度统计学意义（P〈0．01）。②治疗后提肛组消除肛门坠胀时间【（3．44±1．82）d】显著短于对照组（5．48±1．86）d1，控便能力评分【（0．29±0．09）分】均显著低于对照组【（0．44±0．31）分】，差异均有高度统计学意义（P〈0．01）；急便感评分【（0．39±0．15）分】低于对照组f（0．31±0．11）分】，差异有统计学意义（P〈0．05）。结论提肛运动可明显减轻PPH术后肛门坠胀及急便感、增强控便能力。

Research of levator ani movement improving anal pendant expansion after the procedure for prolapse and hemorrhoids operation for severe haemorrhoids

Objective To explore the curative effect of the levator ani movement after the procedure for prolapse and hemorrhoids （PPH） operation. Methods 150 patients with anal pendant expansion after the operation of the PPH±Milligan-Morgan were selected and divided into levator ani group and control group randomly with 75 cases in each group. Patients in levator ani group were requested to do the functional exercise from the third day after surgery and patients in control group were requested just the conventional therapy. The anal pendant expansion points, fecal urgency and the cacation ability were analyzed. Results ①The anal pendant expansion time points of the two groups （0.36±0.08）, （1.16±0.91） scores], the anal pendant expansion degree points of the two groups （0.30±0.07）, （0.93±0.57） scores] after treatment were all lower than those before treatment, the differences were statistically significant （P 〈 0.01）; the anal pendant expansion time points and the anal pendant expansion degree points of the levator ani group after the treatment were lower than the control group, the differences were statistically significant （P 〈 0.01）. ②The anal pendant expansion elimination time of the levator ani group （3.44±1.82） d] was shorter than that of control group （5.48±1.86） d], the cacation ability points of levator ani group （0.29±0.09） scores] was lower than that of control group （0.44±0.31） scores], the differences were statistically significant （P 〈＇0.01）; fecal urgency points of levator ani group （0.39±0.15） scores] was lower than that of control group （0.31 ±0.11） scores], the difference was statistically significant （P 〈 0.05）. Conclusion The levator ani movement can alleviate the anal pendant expansion and fecal urgency, enhance the control ability of defecation.