目的 观察吻合器经肛门直肠切除术(STARR术)联合经直肠闭式修补术(Bresler术)治疗直肠前突的临床效果.方法 收集本院2013年8月至2016年10月直肠前突患者80例,随机均分为观察组与对照组,每组各40例,观察组患者采用STARR术联合Bresler术治疗,对照组患者采用单纯STARR术治疗.于术后3个月时对所有患者进行随访,比较两组患者手术相关指标、治疗效果、手术前后Wexner便秘评分、术后并发症发生率、患者对治疗的满意度.结果 两组患者术中出血量、术后疼痛评分以及住院时间无明显差异(P＞0.05),观察组手术时间多于对照组,术后3个月Wexner便秘评分低于对照组,术后直肠前突距离短于对照组,两组差异具有统计学意义(P＜0.05);两组患者术后并发症发生率差异不明显(P＞ 0.05);治疗后观察组患者对治疗的满意度为92.50％,高于对照组的75.00％,两组差异显著(P＜0.05).结论 STARR术联合Bresler术治疗直肠前突效果良好,能有效改善患者排便功能,具有一定的临床应用价值.%Objective To investigate the effect of stapling anal rectum resection (STARR)combined with transrectal closed repair (Bresler)for the treatment of rectal convex.Methods 80 patients with rectal convex were recruited in our hospital between August 2013 and October 2016.Patients were randomly assigned to treatment group and control group,with 40 cases in each group.Treatment group were treated by STARR surgery and Bresler,and control group by STARR only.We compared between the two groups postoperative complications and patients satisfaction of treatment.Results There was no significantly difference between the two groups in terms of intraoperative blood loss,postoperative pain score,and the length of time (P ＞ 0.05).Operating time was longer,postoperative Wexner constipation score lower,and postoperative rectal convex distance shorter in the treatment group than in the control group (P ＜ 0.05).There was no significant difference in postoperative complications between the two groups (P ＞ 0.05).Treatment satisfaction rate in the treatment group (92.50％)was higher than in the control group (75.00％,P ＜ 0.05).Conclusion STARR operation combined with Bresler has good treatment effect for rectal convex and has potential for clinical application.
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