柯敏辉 黄鸿铃 李雪玉 郑鸣霄 　郑霞霞

【摘要】 目的：比较消痔灵注射术与选择性痔上黏膜切除术（TST）治疗直肠黏膜内脱垂（IRP）的临床效果。方法：选取2020年5月-2021年1月本院收治的40例IRP患者按照随机数字表法分为治疗组和对照组，每组20例。治疗组采用消痔灵注射术，对照组采用TST，觀察比较两组症状积分、疗效、术后并发症、经济因素及客观指标检测等方面的情况。结果：两组各时间点排便频率、排便时间、直肠排不尽感及肛门镜积分比较，差异均无统计学意义（P>0.05）;两组治疗前及治疗后2、8周肛门坠胀积分比较，差异均无统计学意义（P>0.05）;但治疗组治疗后4周肛门坠胀积分低于对照组（P<0.05）;两组组内各时间点症状及肛门镜积分比较，差异均有统计学意义（P<0.05）;两组治疗前与治疗后8周排粪造影与3D直肠测压情况比较，差异均无统计学意义（P>0.05）;但两组治疗后8周排粪造影情况与直肠顺应性较治疗前均改善（P<0.05）;两组总有效率和痊愈率比较，差异均无统计学意义（P>0.05），但治疗组术后并发症发生率、住院时间及费用均低于对照组（P<0.05）。结论：消痔灵注射术操作简单，症状改善明显，与TST术相比，具有并发症少、住院时间短、价格低廉的优点，是直肠黏膜内脱垂较理想的治疗方法。

【关键词】 消痔灵 选择性痔上黏膜切除术 直肠黏膜内脱垂

Comparison of Effects of Xiaozhiling Injection Surgery and TST in the Treatment of Internal Rectal Prolapse/KE Minhui， HUANG Hongling， LI Xueyu， ZHENG Mingxiao， ZHENG Xiaxia. //Medical Innovation of China， 2021， 18（34）： 076-081

[Abstract] Objective： To compare the clinical effects of Xiaozhiling injection surgery and tissue-selecting therapy stapler （TST） in the treatment of internal rectal prolapse （IRP）. Method： A total of 40 patients with IRP in our hospital from May 2020 to January 2021 were randomly divided into the treatment group and the control group according to the random number table， 20 cases in each group. The treatment group was treated with Xiaozhiling injection， and the control group was treated with TST. The symptom score， curative effect， postoperative complications， economic factors and objective indicators of two groups were observed and compared. Result： There were no significant differences in defecation frequency， defecation time， rectal continence and anoscope score between two groups at each time point （P>0.05）. There were no significant differences in anal distension scores between two groups before treatment and 2 and 8 weeks after treatment （P>0.05）; but the anal distension score in the treatment group 4 weeks after treatment was lower than that in the control group （P<0.05）. There were significant differences in symptoms and anal endoscopy scores between two groups at each time point （P<0.05）; There were no significant differences in defecography and 3D rectal manometry between two groups before treatment and 8 weeks after treatment （P>0.05）. However， the defecography and rectal compliance of two groups 8 weeks after treatment were improved （P<0.05）. There were no significant differences in the total effective rate and cure rate between two groups （P>0.05）， but the incidence of postoperative complications， length of hospital stay and cost in the treatment group were lower than those in the control group （P<0.05）. Conclusion： Xiaozhiling injection surgery is simple and the symptoms are obviously improved， compared with TST， it has the advantages of fewer complications， shorter hospital stay and lower price， so it is an ideal treatment for IRP.

[Key words] Xiaozhiling Tissue-selecting therapy stapler Internal rectal prolapse

First-author’s address： The Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine， Fuzhou 350003， China

doi：10.3969/j.issn.1674-4985.2021.34.018

直肠黏膜内脱垂（internal rectal prolapse，IRP）是指因直肠黏膜层与肌层之间的结缔组织出现松弛，在排便过程中近侧的肠壁折入远侧的肛管或肠腔中，但未超出肛门外缘且在排便后仍然存在[1-2]。……