Objective To evaluate the efficacy of modified Delorme operation for treating proctoptosis.Methods Eighty-two patients with proctoptosis were selected in the Central Hospital of Xinxiang,Xinhua Hospital of Xinxiang,the Traditional Chinese Medicine Hospital of Xinxiang and he County Hospital of Fengqiu from January 2010 to June 2015.The patients were divided into control group and observation group according to operation methods,41 cases in each group.The patients in the control group were treated with Delorme operation,and the patients in the observation group were treated with modified Delorme operation (Delonne operation and postanal repair and anal levator plasty).The relevant indexes of postoperative patients in the two groups were analyzed.Results The operation time in the observation group was significantly longer than that in the control group(P ＜ 0.05),but there was no significant difference in the length of stay and the rate of postoperative complication between the two groups(P ＞ 0.05).A year and a half after operation,the constipation scores,fecal incontinence ratio and recurrence rate in the observation group were significantly lower than those in the control group(P ＜ 0.05),the satisfaction score in the observation group was significantly higher than that in the control group(P ＜0.05).The results of anorectal manometry showed that maximum resting pressure and maximum squeeze pressure after operation were significantly higher than that of before operation,rectal sensation capacity was significantly lower than that of before operation (P ＜ 0.05).The maximum resting pressure and maximum squeeze pressure in the observation group were significantly higher than those in the control group(P ＜ 0.05),the rectal sensation capacity in the observation group was significantly lower than that in the control group(P ＜ 0.05).Conclusion Modified Delorme operation has the long term reliable effect,low recurrence rate and high safety.%目的 评价改良Delorme手术治疗直肠脱垂的临床效果.方法 选取2010年1月至2015年6月新乡市中心医院、新乡市新华医院、新乡市中医院、封丘县人民医院等4家医院收治的直肠脱垂患者82例,根据手术方式将患者分为对照组和观察组,每组41例.对照组患者采用Delorme手术,观察组患者采用改良Delorme手术(Delorme手术+肛管后方修补术+肛提肌成形术).对2组患者术后相关指标进行观察.结果 观察组患者手术时间长于对照组(P＜0.05),但2组患者住院时间和术后并发症发生率比较差异无统计学意义(P＞0.05).术后1.5a,观察组患者便秘评分、大便失禁患者比率及复发率显著低于对照组,满意度评分高于对照组(P＜0.05);2组患者肛门直肠压力测定结果显示,术后最大静息压及最大收缩压较术前显著升高,直肠感觉容量较术前显著降低(P＜0.05),观察组患者最大静息压及最大收缩压显著高于对照组,直肠感觉容量显著低于对照组(P＜0.05).结论 改良Delorme手术远期效果可靠,复发率低,安全性高.
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