AIM: To compare the clinical efficacies of two surgical procedures for hemorrhoid rectal prolapse with outlet obstruction-induced constipation.METHODS: One hundred eight inpatients who underwent surgery for outlet obs...AIM: To compare the clinical efficacies of two surgical procedures for hemorrhoid rectal prolapse with outlet obstruction-induced constipation.METHODS: One hundred eight inpatients who underwent surgery for outlet obstructive constipation caused by internal rectal prolapse and circumferential hemorrhoids at the First Affiliated Hospital of Xinjiang Medical University from June 2012 to June 2013 were prospectively included in the study.The patients with rectal prolapse hemorrhoids with outlet obstructioninduced constipation were randomly divided into two groups to undergo either a procedure for prolapse and hemorrhoids(PPH)(n = 54) or conventional surgery(n = 54; control group).Short-term(operative time,postoperative hospital stay,postoperative urinary retention,postoperative perianal edema,and postoperative pain) and long-term(postoperative anal stenosis,postoperative sensory anal incontinence,postoperative recurrence,and postoperative difficulty in defecation) clinical effects were compared between the two groups.The short- and long-term efficacies of the two procedures were determined.RESULTS: In terms of short-term clinical effects,operative time and postoperative hospital stay were significantly shorter in the PPH group than in the control group(24.36 ± 5.16 min vs 44.27 ± 6.57 min,2.1 ± 1.4 d vs 3.6 ± 2.3 d,both P < 0.01).The incidence of postoperative urinary retention was higher in the PPH group than in the control group,but the difference was not statistically significant(48.15% vs 37.04%).Theincidence of perianal edema was significantly lower in the PPH group(11.11% vs 42.60%,P < 0.05).The visual analogue scale scores at 24 h after surgery,first defecation,and one week after surgery were significantly lower in the PPH group(2.9 ± 0.9 vs 8.3 ± 1.1,2.0 ± 0.5 vs 6.5 ± 0.8,and 1.7 ± 0.5 vs 5.0 ± 0.7,respectively,all P < 0.01).With regard to long-term clinical effects,the incidence of anal stenosis was lower in the PPH group than in the control group,but the difference was not significant(1.85% vs 5展开更多
目的:本研究通过对直肠内脱垂伴环状混合痔所致出口梗阻性便秘两种不同术式的近期、远期的临床疗效观察及直肠测压对两种不同术式术前和术后肛门功能客观评价,探索该类型便秘的更好治疗方法.方法:对2010-01/2012-12就诊并接受住院治疗的...目的:本研究通过对直肠内脱垂伴环状混合痔所致出口梗阻性便秘两种不同术式的近期、远期的临床疗效观察及直肠测压对两种不同术式术前和术后肛门功能客观评价,探索该类型便秘的更好治疗方法.方法:对2010-01/2012-12就诊并接受住院治疗的120例直肠内脱垂伴环状混合痔患者,采用随机区组分组方法分为两组,试验组[吻合器痔上黏膜环切术(procedure forprolapse and hemorrhoids,PPH)],对照组(传统术式,即混合痔外剥内扎+直肠黏膜套扎),两组术前术后分别进行直肠肛门压力检测,分析两组患者手术前后肛门功能指标的肛肠压力变化和便秘患者生活质量评价表(The Patient Assessment of Constipation Quality of Life,PAC-QOL).结果:直肠肛门测压研究中,两组手术后的直肠肛门检测出现不同程度的减弱.试验组患者的术前与术后各项直肠肛门测压指标差异无统计学意义(P>0.05),表明吻合器痔上黏膜环切术没有对患者的肛门功能造成影响,不改变正常肛门功能,对照组患者的术前与术后除直肠静息压外,各项肛门直肠测压指标差异有统计学意义(P<0.05).试验组和对照组术前术后差异比较,除直肠静息压外均有统计学意义(P<0.05),表明传统术式对正常的肛门功能造成了一定影响.两组患者手术后进行跟踪随访,通过应用生活质量量表的评价,PPH手术与传统手术相比各维度及总分的差异均有统计学意义,PPH术式组表现较好的生活质量.结论:采用PPH手术方式解决直肠内脱垂同时伴环状混合痔所致出口梗阻性便秘,跟传统术式(混合痔外剥内扎术+直肠黏膜套扎术)作比较,临床疗效优于后者,而且前者表现出较高的生活质量,值得临床上推广.展开更多
文摘AIM: To compare the clinical efficacies of two surgical procedures for hemorrhoid rectal prolapse with outlet obstruction-induced constipation.METHODS: One hundred eight inpatients who underwent surgery for outlet obstructive constipation caused by internal rectal prolapse and circumferential hemorrhoids at the First Affiliated Hospital of Xinjiang Medical University from June 2012 to June 2013 were prospectively included in the study.The patients with rectal prolapse hemorrhoids with outlet obstructioninduced constipation were randomly divided into two groups to undergo either a procedure for prolapse and hemorrhoids(PPH)(n = 54) or conventional surgery(n = 54; control group).Short-term(operative time,postoperative hospital stay,postoperative urinary retention,postoperative perianal edema,and postoperative pain) and long-term(postoperative anal stenosis,postoperative sensory anal incontinence,postoperative recurrence,and postoperative difficulty in defecation) clinical effects were compared between the two groups.The short- and long-term efficacies of the two procedures were determined.RESULTS: In terms of short-term clinical effects,operative time and postoperative hospital stay were significantly shorter in the PPH group than in the control group(24.36 ± 5.16 min vs 44.27 ± 6.57 min,2.1 ± 1.4 d vs 3.6 ± 2.3 d,both P < 0.01).The incidence of postoperative urinary retention was higher in the PPH group than in the control group,but the difference was not statistically significant(48.15% vs 37.04%).Theincidence of perianal edema was significantly lower in the PPH group(11.11% vs 42.60%,P < 0.05).The visual analogue scale scores at 24 h after surgery,first defecation,and one week after surgery were significantly lower in the PPH group(2.9 ± 0.9 vs 8.3 ± 1.1,2.0 ± 0.5 vs 6.5 ± 0.8,and 1.7 ± 0.5 vs 5.0 ± 0.7,respectively,all P < 0.01).With regard to long-term clinical effects,the incidence of anal stenosis was lower in the PPH group than in the control group,but the difference was not significant(1.85% vs 5
文摘目的:本研究通过对直肠内脱垂伴环状混合痔所致出口梗阻性便秘两种不同术式的近期、远期的临床疗效观察及直肠测压对两种不同术式术前和术后肛门功能客观评价,探索该类型便秘的更好治疗方法.方法:对2010-01/2012-12就诊并接受住院治疗的120例直肠内脱垂伴环状混合痔患者,采用随机区组分组方法分为两组,试验组[吻合器痔上黏膜环切术(procedure forprolapse and hemorrhoids,PPH)],对照组(传统术式,即混合痔外剥内扎+直肠黏膜套扎),两组术前术后分别进行直肠肛门压力检测,分析两组患者手术前后肛门功能指标的肛肠压力变化和便秘患者生活质量评价表(The Patient Assessment of Constipation Quality of Life,PAC-QOL).结果:直肠肛门测压研究中,两组手术后的直肠肛门检测出现不同程度的减弱.试验组患者的术前与术后各项直肠肛门测压指标差异无统计学意义(P>0.05),表明吻合器痔上黏膜环切术没有对患者的肛门功能造成影响,不改变正常肛门功能,对照组患者的术前与术后除直肠静息压外,各项肛门直肠测压指标差异有统计学意义(P<0.05).试验组和对照组术前术后差异比较,除直肠静息压外均有统计学意义(P<0.05),表明传统术式对正常的肛门功能造成了一定影响.两组患者手术后进行跟踪随访,通过应用生活质量量表的评价,PPH手术与传统手术相比各维度及总分的差异均有统计学意义,PPH术式组表现较好的生活质量.结论:采用PPH手术方式解决直肠内脱垂同时伴环状混合痔所致出口梗阻性便秘,跟传统术式(混合痔外剥内扎术+直肠黏膜套扎术)作比较,临床疗效优于后者,而且前者表现出较高的生活质量,值得临床上推广.
