目的 观察痔上粘膜环切术(PPH)联合直肠前壁柱状缝合术治疗重度直肠前突疗效。方法 将我院2014年1月-2017年 1月间收治的106例重度直肠前突患者采用随机数字法随机分为观察组(PPH+直肠前壁柱状缝合术，n=53)与对照组 (Block，n=53)，比较两者手术时间、住院时间、术后出血率，出口梗阻型便秘症状改善情况，治疗有效率与复发 情况。结果 观察组手术时间、住院时间、术后出血率分别为[(20.36±4.23)min、(7.36±1.65)d、3.77%]显著低 于对照组的[(31.26±7.12)min、(10.23±2.45)d、15.09%](P＜0.05)；术后随访3个月，两组出口梗阻型便秘情 况均得以改善，且观察组改善情况更明显(P＜0.05)；随访6个月统计两组治疗有效率分为为92.45%和64.15%，(P ＜0.05)，复发率分别为3.77%和15.09%(P＜0.05)。结论 PPH联合直肠前壁柱状缝合术可有效缩短重度直肠前突手 术、住院时间，减少术后出血率，改善口梗阻型便秘情况，提高治疗效果，降低复发率，值得临床推广。

Objective To observe the effect of procedure for prolapse and hemorrhoids (PPH) combined with rectal antetheca styloid suture on severe rectocele. Methods 106 patients with severe rectocele treated in our hospital form Jan. 2014 to Jan. 2017 were randomly divided into observation group (PPH + rectal antetheca styloid suture, n=53) and control group (Block, n=53). The operation time, hospital stay, postoperative bleeding rates, symptom improvement of outlet obstructive constipation, effective rates and recurrence rates in the two groups were compared. Results The operation time, hospital stay and postoperative bleeding rate in the observation group were(20.36±4.23)min,(7.36±1.65) d and 3.77% which were significantly lower than those in the control group(31.26±7.12)min,(10.23±2.45)d and 15.09%(P<0.05), after 3 months follow-up, the symptoms of outlet obstruction constipation in the two group were both improved, and the improvement in the observation group was better than that in the control group (P<0.05), after 6 months follow-up, the effective rate in the observation group was 92.45% which was significantly higher than that in the control group 64.15% (P<0.05), the recurrence rates in the observation group was 3.77% which was significantly lower than that in the control group 15.09% (P<0.05). Conclusion PPH combined with rectal antetheca styloid suture which is worthy of promotion, can effectively shorten the operation time of severe rectocele and hospital stay, reduce the postoperative bleeding rate and recurrence rate, and improve the symptoms of outlet obstruction constipation and therapeutic effect.