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完全性直肠脱垂并前突行腹膜片交叉悬吊固定及补片修复20例疗效分析

Application of cross ventr of fixation and patch repair treatment for complete rectal prolapse and rectocele by fiber peritoneum and patch : analysis of 20 eases
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摘要 目的探讨一种有效治疗完全性直肠脱垂合并直肠前突引起便秘的方法。方法2005年9月至2009年6月,对20例完全性直肠脱垂并直肠前突患者进行了腹膜片十字交叉直肠悬吊固定加补片[聚丙烯网(polypropylenemesh)]修补,将直肠游离到肛提肌水平,和聚丙烯网片加强直肠阴道隔,网片下缘在肛提肌水平环绕直肠,在直肠前方用丝线缝合网片和直肠浆肌层;游离腹膜片十字交叉缝合固定于直肠前壁浆肌层,悬吊固定直肠前壁于骶骨岬前筋膜。缝合关闭盆底腹膜。结果20例患者手术均顺利完成,手术时间60.5min(55~65min),出血量50ml。本组无手术死亡和腹部并发症发生。术后随访2个月至3年症状无复发。便秘症状完全缓解17例,基本缓解5例,直肠脱垂无复发。结论游离腹膜片十字交叉直肠前壁悬吊固定并补片修复直肠前壁能同时解决直肠脱垂和直肠前突两大问题,安全有效。 Objective To evaluate a kind of effective treatment of constipation by complete rectal prolapse and reetocele. Methods From September 2005 to June 2009, application of cross ventr of fixation and patch ( polypropylene mesh) repair to treat 20 eases of complete rectal prolapse as well as reetoeele. Dissociate the rectal to the level of levator and reinforce reetovaginal septum by polypropylene mesh. The inferior border of the polypropylene mesh encircle rectum at the level of levator and suture polypropylene mesh to the membrane and muscular coat of the rectum at the front of rectum by the silk. Then dissociate abdominal membrane patch and suture to the membrane and museular coat of the anterior reetum by cross to suspension and fix anterior rectum at the sacrum nape fascia. At last, shut off abdominal membrane of the sink. Results The progress of operation of 20 eases is successfully, the average time of the operation is 60.5 min (55 -65 rain)and the hemorrhage volume is 50 ml. There is no death and complication of the abdomen, the symptom of the rectal prolapse and costive is not occurrence during 2 month to 3 years after operation. Complete remission of constipation symptoms in 17 cases, the basic ease in 3 cases, no recurrence of rectal prolapse. Conclusion Dissociative peritoneum paeh suspension fixation at the anterior rectum by cross and polypropylene mesh repair anterior rectum can solve rectal prolapse and rectocele at the same time are safe and in effect.
作者 宋斌 张国云
机构地区 郑州市中心医院
出处 《中国医学创新》 CAS 2010年第5期53-54,共2页 Medical Innovation of China
关键词 直肠脱垂 直肠前突 游离腹膜片 悬吊固定术 Rectal prolapse Anterior reetocele Dissociative abdominal patch Suspension fixation
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