直肠黏膜柱状缝合联合PPH治疗直肠前突的疗效观察

为探讨直肠黏膜柱状缝合（Block术）联合吻合器痔上黏膜环切术（PPH）治疗直肠前突（RC）的疗效，将58例Rc患者随机分为治疗组和对照组各29例，治疗组行Block术加PPH治疗，对照组行单纯Block术治疗。比较两组手术情况及术后第1次、1周、1个月、3个月排便情况及LongoODS评分。结果显示，治疗组手术情况均优于对照组。随访结果，两组术后第1次、术后1周和术后1个月排便情况差异无统计学意义（P〉0．05）；两组术后3个月排便情况差异有统计学意义（P〈0．05）。I．ongoODS评分比较，两组术后1个月和术后3个月与术前比较差异具有统计学意义（P〈0．05）；治疗组术后1个月和术后3个月比较差异无统计学意义（P〉0．05）；对照组术后3个月比术后1个月高，差异有统计学意义（P〈0．05）；两组术后1个月比较差异无统计学意义（P〉0．05）；治疗组术后3个月低于对照组，差异有统计学意义（P〈0．05）。结果表明，Block术加PPH治疗RC可明显改善患者术后排便情况，提高患者生活质量，且该术式的手术情况和远期疗效较单纯行Block术效果更好。

Clinical Observation on Block Porcedure Combined with PPH for Rectocele

This study was to investigate the clinical effica mucosa） combined with PPH in treating rectocele（RC）, cy of Block procedure（cylinder suture for rectal 58 cases of RC were randomized into treatment group and control group, 29 cases for each group. Treatment group underwent Block procedure combined with PPH,while control group received PPH alone. Both groups were compared for the condition during operation, the first time for bowel movement, the bowel movement during the 1st week, 1st month, and 3rd month after operation,and Longo＇s ODS scores.The results showed that treatment group was superior to control group in the condition during operation; no significant difference was found between the two groups in the first time for bowel movement,the bowel movement during the 1st week and 1st month after operation（ P 〉0.05） ; there was significant difference in the bowel movement during the 3rd month after operation（ P 〈0. 05 ）. Longo＇s ODS scores in both groups showed significant difference during the 1st month,and 3rd month after operation from those before operation（ P 〈0.05）.In treatment group,Longo＇s ODS scores during the 1st month after operation showed no significant difference from those during the 3rd month after operation（ P〉0.05）.In control group, Longo＇s ODS score during the 3rd month after opera- tion was significantly higher than that during the 1st month after operation（ P 〈0.05）.There was no sig- nificant difference between two groups in Longo＇s ODS score during the 1st month after operation（ P 〉0.05）.In treatment group,Longo＇s ODS score during the 3rd month after operation was significantly lower than that in the controls（ P 〈0.05）.It is concluded that Block procedure combined with PPH in treating RC can obviously improve the bowel movement,improve the quality of life of RC patients, and is superior to single Block procedure in surgery and long-term efficacy.