CAJ | 학술논문

目的：探讨选择性痔上黏膜吻合术（TST）治疗出口梗阻性便秘的疗效。方法将120例出口梗阻性便秘患者根据随机数字表法分为观察组60例和对照组60例，观察组采用TST治疗，对照组采用传统手术治疗，记录并比较两组患者术前及术后3个月时的肛管静息压、初始排便阈值、最大排便阈值、直肠最大收缩压及临床疗效。结果观察组60例患者中17例痊愈，25例显效，11例有效，有效率88．33％。对照组60例患者12例痊愈，13例显效，7例有效，有效率53．33％，两组有效率差异有统计学意义（χ2＝17．788，P＜0．05）。观察组术后肛管静息压、初始排便阈值、最大排便阈值和直肠最大收缩压分别是（43．79±12．93） mmHg、（58．46±17．11） mL、（130．44±19．91） mL 和（126．63±19．22） mmHg。对照组对应的指标参数分别是（51．24±16．18）mmHg、（64．54±14．89）mL、（137．89±16．04）mL和（119．41±17．01）mmHg，两组差异均有统计学意义（t＝2．786、2．179、2．076、2．257，均P＜0．05）。结论 TST治疗出口梗阻性便秘是一种安全、有效的手术方式，值得在临床上推广应用。
목적：탐토선택성치상점막문합술（TST）치료출구경조성편비적료효。방법장120례출구경조성편비환자근거수궤수자표법분위관찰조60례화대조조60례，관찰조채용TST치료，대조조채용전통수술치료，기록병비교량조환자술전급술후3개월시적항관정식압、초시배편역치、최대배편역치、직장최대수축압급림상료효。결과관찰조60례환자중17례전유，25례현효，11례유효，유효솔88．33％。대조조60례환자12례전유，13례현효，7례유효，유효솔53．33％，량조유효솔차이유통계학의의（χ2＝17．788，P＜0．05）。관찰조술후항관정식압、초시배편역치、최대배편역치화직장최대수축압분별시（43．79±12．93） mmHg、（58．46±17．11） mL、（130．44±19．91） mL 화（126．63±19．22） mmHg。대조조대응적지표삼수분별시（51．24±16．18）mmHg、（64．54±14．89）mL、（137．89±16．04）mL화（119．41±17．01）mmHg，량조차이균유통계학의의（t＝2．786、2．179、2．076、2．257，균P＜0．05）。결론 TST치료출구경조성편비시일충안전、유효적수술방식，치득재림상상추엄응용。
Objective To investigate the effect of the selective hemorrhoid mucosa anastomosis ( TST) thera-peutic outlet obstruction constipation ( OOC) .Methods 120 patients with outlet obstruction constipation were divided into the observation group and control group , the observation group was treated with selective hemorrhoidal mucosa anastomosis(TST),the control group weree dealed with traditional surgical treatment ,follow-up for at least three months according to the random number table , anal resting pressure groups of patients before and after surgery at 3 months,the initial defecation threshold ,the maximum threshold defecation ,anal maximum efficacy in patients with systolic blood pressure and so on were recorded and compared .Results 17 cases were cured in the observation group,25 cases markedly effective,11 cases effective,the effective rate of 88.33%.60 patients in the control group 12 cases cured,13 cases markedly effective,7 cases effectively,the effective rate was 53.33%,the difference was significant(χ2 =17.788,P<0.05).The postoperative anal resting pressure ,initial defecation threshold ,the maximum threshold bowel and rectum,the maximum systolic blood pressure of the observation group were (43.79 ±12.93)mmHg, (58.46 ±17.11) mL,(130.44 ±19.91) mL and (126.63 ±19.22) mmHg,respectively.The parameters in the control group(51.24 ±16.18)mmHg,(64.54 ±14.89)mL,(137.89 ±16.04)mL and (119.41 ±17.01)mmHg. The difference was statistically significant between the two groups (t=2.786,2.179,2.076,2.257,all P<0.05). Conclusion Selective treatment of hemorrhoids mucosa anastomosis outlet obstruction constipation is a safe and effective surgical approach ,which is worthy of clinical application .