STARR手术治疗出口梗阻型便秘的临床研究

来源 :中华中医药学会肛肠分会第五届理事会换届会议暨全国肛肠学术交流大会 | 被引量 : 0次 | 上传用户:Haroldzhang
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STARR(Stapled Transanal Rectal Resection)手术是近年来意大利学者Longo A提出的用于治疗出口梗阻型便秘的新术式,此术式提出后在欧洲国家得到公认,本科自2005年9月至2009年9月以来共行STARR手术34例.平均手术时间为35.2±7.6min,平均住院时间5±2d,术后尿漪留6例(17.6%),术后72h患者有不同程度的肛门下坠感及憋胀感,有3例病人术后48h内需用止痛药物缓解,无大出血、感染、肛门失禁及肛门狭窄,无肠痪;肛缘外观平整,无肛缘水肿。术后1个月,所有病例排便困难症状缓解,排便较术前畅通,肛门堵塞感消失,便秘评分情况较好。2例患者术后1个月内出现轻度肛门失禁,表现为内衣污粪,1月后好转。术后6个月复查直肠指诊示直肠袋状凹陷消失。排粪造影证实直肠前突消失或深度变浅,直肠黏膜脱垂或内套叠消失。
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慢性功能性便秘(CFC)是一组多人群发病、多因素存在,以大便排出困难、排便不适感及排便时程延长为主诉的症候群.2005年以来,学习直肠瓣悬挂结扎注射手术,用于治疗慢性功能性便秘,取得较好疗效.回顾追踪2008年10月至2009年1月资料较为完整的42例治疗情况。通过悬挂结扎注射使松驰下垂的直肠钻膜薪连固定,增宽重叠的直肠瓣缩小复位,直肠腔道恢复通畅,有效地降低了肛门出口排便阻力。观察表明,该法治疗