| ObjectiveTo observe curative effect about the therapy of xiaozhiling Eight steps injections in Pararectal space(PaRs) for Full-thickness Rectal prolapse(FTRP) and try to study the pathogenesis of the disease, as well as the treatment mechanism of Xiaozhiling injection for FTRP.MethodsFrom February 2011 to October 2015,63 cases with FTRP were referred to the department of Proctology in Guang’anmen Hospital. They were subjected to prospective clinical study. Using Xiaozhiling Eight steps injections in PaRs to treat all cases, consummating preoperative preparations,and postoperative fasting for 3-5 days is necessary.All cases need antibiotics and parenteral nutrition after operation.They must control of bowel movements for 3-5 days.Observe patients’age, gender and other basic informations,sign scores to the associated preoperative and postoperative symptoms.One day before operation and 15 days after, We check cases using Magnetic Resonance Imaging(MRI) and Double Contrast Radiograph(DCR).Make some statistical analysis of all the results,and record the recurrence in patients with follow-up.Results1.During a follow-up period of 0.5- 5 years, all the 63 patients were studied. The outcome after injection treatment was classified in three categories:Cured:n=51 (80.95%);Improved:n=10(15.87%);Failure (fully recurrent):n=2(3.18%). The total effective rate was 96.82%. During the period of treatment, the symptom of patients with prolapse achieve fully improved, the rests of the symptoms including perianal secretions, pain, constipation, and so on,have different degrees of improvement before and after the treatment, especially the curative effect of preoperative and postoperative recent scores were significantly different.Before and after surgery in patients had no serious abnormalities with blood routine and biochemical indicators.2.The postoperative follow-up six months to five years, and follow-up of 63 cases presented with rectal mucosal prolapse of 10 cases,12 cases complained of secretions,6 cases of anal inside the belly uncomfortable, complete RP recurred in 2 cases, asking for abdominal sigmoid colon suspension surgery.Follow-up of 63 cases of patients, mucosal prolapse and recurrence of a total of 12 cases, completely continuous recurrence time, compared with 95.23% three months without recurrence,1 year for 87.30%, the rate of no recurrence for 2 years reached 80.95%.All patients with recurrent relapse within 2 years.Of 0 to 3 months, the recurrence rate of 25%,4 to 6 months,7-9 months,9-12 months recurrence rate of 16.7%,8.3%,16.7%,0-12 months recurrence cases accounted for 66.7% of total recurrent cases.Conclusion1.The Eight steps injection of Xiaozhiling in PaRs curatively effect on FTRP, small trauma, economy, safety etc. Large dose injection also do not appear the damage of hepatorenal function,because of the low rate of recurrence,Local infection and necrosis and easily to operate, it is suitable for all levels of hospitals.In addition,patients are easy to accept, to facilitate clinical apptlication and dissemination.So, all can be used as the preferred treatment of complete RP.2.According to the group of patients with general situation analysis,the patients of FTRP generally have long course of disease, larger range of illness age, the smaller difference between the sexes, and the triggers about the disease are not clear, and the disease have no clear professional associations.But it still needs a larger sample size to be analyzed.3.Pelvic MRI and DCR have great advantage in the evaluation of pelvic floor anatomy, they can clearly reflect the function of the organs and tissues around the anorectal, anatomical and status, to explore the pathogenesis of rectal prolapse, enhancing diagnosis value of the rectal prolapse, should be used as a routine inspection means of rectal prolapse. |
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