柯敏辉 郑鸣霄 石荣 吴华嵩 魏霖 程佑民 翁英

【摘 要】 目的：研究兔直肠粘膜内脱垂（Internal Rectal Prolapse，IRP）发展的阶段性特征，旨在推断IRP的发生机制。方法：将156只兔（雄兔、雌兔各78只），按随机数字表随机分为4组，分别为正常组、造模早期组、造模中期组、造模晚期组，分别于不同阶段取兔解剖，进行力学与病理学分析。结果：造模不同时期兔直肠组织的力学指标均存在统计学差异；造模不同阶段兔直肠组织的镜下征象存在差异；在造模不同时期雌兔与雄兔的力学指标与病理特征差异无统计学意义。结论：不同病理学阶段的兔肛门直肠力学特性存在差异，可能是IRP的发生机制之一。

【关键词】 筋脉横解，肠澼为痔；直肠粘膜内脱垂；机制；有限元；HE染色

【中图分类号】R-332 【文献标志码】 A 【文章编号】1007-8517（2018）03-0043-05

Abstract：Objective In order to infer the mechanism of IRP， research the stage characteristics of the IRP rabbit. Methods There were 156 rabbits （78 males and 78 females）.They were randomly divided into four groups according to the random number table， including the group of the normal group， the early stage group， the middle group and the late stage group. At different periods， the rabbits were dissected and analyzed in mechanics and pathology. Results The mechanical indexes of rectal tissue were different in different period. The image of the rectal tissue at different stages was different. The mechanical indicators and pathological features of female rabbits and male rabbits were not different in different period. Conclusion There were significant differences in the mechanical properties of the anorectal of rabbits in different pathological stages. It could be one of the mechanisms of IRP.

Keywords：Sinews and Channels Flaccid， Changpi and Haemorrhoids；Internal Rectal Prolapse；Mechanism；Finite Element；HE Dyed

直肠粘膜内脱垂（Internal Rectal Prolapse，IRP）是出口型便秘的常见病因之一，发病率为外脱垂的3～10倍[1]。临床表现为排便困难、排便不尽感、排便次数增多[2]和慢性肛门疼痛[3]等症状。临床上采用注射疗法[4]、STARR手术[5]等方法治疗有效，但有专家认为外科手术对改善IRP症状无效[6]。分析治疗失败的原因，主要与目前对IRP的本质及病变过程未明确有关[7]。笔者旨在前期IRP动物模型[8]的基础上，研究IRP发生的阶段性特征，探讨IRP的发生机制，以期对临床治疗提供理论依据。

1 材料与方法

1.1 动物 174只健康新西兰兔，雌雄各半，1月龄，体重0.7～0.8kg，分别编号。由上海松联实验动物养殖场提供[许可证号：scxk（沪）2012-0011]。兔由福建省中医药研究院比较医学研究中心统一饲养，对兔的处置符合中《关于善待实验动物的指导性意见》[9] 中的规定。……