目的评价痔上黏膜环切术（PPH)加芍倍注射术治疗中重度（排粪造影检查提示突出深度大于16 mm）直肠前突的疗效。方法回顾性分析我院2006年12月至2010年9月期间应用PPH加芍倍注射术治疗的45例中重度直肠前突患者的临床资料，分析其手术时间、住院时间及复发和并发症发生情况。结果本组患者手术时间为(18.8±2.2) min （15～25 min），住院时间为(7.2±0.6) d (6～8 d)。术后随访(12.3±6.6)个月(6～30个月)。34例(75.6%)排便费力、肛门堵塞、下坠等不适症状完全缓解; 10例(22.2%)症状明显缓解，有轻度肛门下坠感，可忍受; 1例(2.2%)术后排便困难症状缓解，但肛门下坠感明显，6个月后缓解。1例(2.2%)于术后25个月再次出现排便费力症状，排粪造影检查提示直肠前突深度为17 mm(术前34 mm)。45例患者术中及术后均未发生大出血、直肠狭窄、直肠阴道瘘等并发症。结论PPH加芍倍注射术治疗中重度直肠前突具有创伤小、术后恢复快、疗效显著、并发症少等优点，但是患者术后养成良好的排便习惯很重要。
Objective To compare the therapeutic effect of procedure for prolapse and hemorrhoids （PPH） and Block repair procedure for rectocele．Methods A retrospective study of 62 patients with surgical treatment for rectocele was analyzed．The patients were divided into PPH group （n=32） and Block group （n=30） according to the different operation procedure．The symptoms score of improvement of the patients after surgery was compared between the two groups， including operation time，intraoperative blood loss， postoperative pain score， required analgesic times， postoperative complications，hospitalization time，and hospitalization expenses．Results The symptoms of constipation of patients in two groups was significantly improved afer operation．Comparing one month with three months of Longo’s obstructed defecation syndrome （ODS） score after the operation，there was no significant difference in the PPH group（P＞0.05）， but significant difference in the Block group（P＜0.01）．Although the expenses of the PPH group was much higher than that of the Block group （P＜0.01）， the outcomes of the PPH group were much better than those of the Block group （P＜0.01）， including the postoperative Longo’s ODS score of one month and three months，operation time，intraoperative blood loss， postoperative pain score，required analgesic times，and hospitalization time．Two cases of lightly postoperative incontinence occurred in the PPH group，but completely recovered after three months in the clinical follow-up．Conclusions The PPH is as safe and effective as Block repair procedure for rectocele. The short time effect and lower recurrence rate of the PPH are better than those of the Block repair procedure．
Objective To evaluate the safety and efficacy of procedure for prolapse and hemorrhoids （PPH） combined with Shaobei injection in treatment for obstructed defecation syndrome （ODS） caused by rectocele. Methods Seventy-two female patients with rectocele from December 2009 to January 2011 in this hospital were divided into PPH combined with Shaobei injection group （36 cases） and only PPH group （36 cases）. The Longo ODS score was performed on week one，month one，month three，and month six after operation，respectively；pain was evaluated， complications such as urine retention，postoperative bleeding，and anal function were observed；hospital stay and recovery work time were recorded in two groups. Results All patients were followed up for 6 months，there were no significant differences in complications，hospital stay，and the Longo ODS score on week one and month one after operation between two groups （P＞0.05）. But the Longo ODS score of the PPH combined with Shaobei injection group on month three and month six after operation were significantly lower than those of the only PPH group （P＜0.05）. Conclusion PPH combined with Shaobei injection has a better efficacy as compared with only PPH，and at least as safe as only PPH.
目的 评价注射用英夫利西单抗治疗难治性溃疡性结肠炎（UC） 的疗效。方法 回顾性分析2009年10月至2012年10月期间，在中国医科大学附属第四医院肛肠外科住院并接受注射用英夫利西单抗治疗的9例中重度激素难治性UC患者的临床疗效。结果 经注射用英夫利西单抗治疗后，7例中度UC患者中，1例完全缓解，4例有效，1例疗效不详，1例无效；2例重度UC者中，1例有效，1例无效。临床缓解及治疗有效的6例患者的血红蛋白水平较治疗前上升，红细胞沉降率及C反应蛋白水平均下降。3例具有肠外表现者的肠外症状均得到改善。结论 对于激素抵抗或激素依赖的中重度UC患者，注射用英夫利西单抗可以有效缓解患者的临床症状。
目的总结肛周坏死性筋膜炎（PNF）的临床特点、诊断及治疗方法。 方法回顾性分析我院肛肠外科2007年1月至2012年12月期间收治的22例PNF患者的临床资料。 结果全部病例均行手术治疗，术中彻底清创，术后给予抗炎、对症、支持治疗。痊愈18例，死亡4例。痊愈病例随访6个月未见复发。 结论PNF早期临床表现无特异性，诊断主要依据临床表现及相关影像学检查，治疗以手术为主，早期诊断，及时治疗，是治愈PNF、降低死亡率的关键。