【摘要】 目的 探讨经肛吻合器直肠切除术（STARR）对出口梗阻型便秘（ODC）直肠组织钙激活氯通道蛋白1(TMEM16A)、机械敏感性离子通道蛋白（Piezo）1、Piezo2的影响。方法 选取2019年1月至2023年6月沧州市中心医院收治的110例ODC患者，按随机数表法将其分为传统组（予传统手术，n=55）、STARR组（予STARR,n=55），比较两组TMEM16A和Piezo1、2水平、肛门直肠动力学指标、应激炎症指标、便秘情况、并发症。结果 治疗后，STARR组TMEM16A和Piezo1、2水平高于传统组，差异有统计学意义（P<0.05）;STARR组直肠最大耐受容量（MTV）、肛管静息压（ARP）、初始感觉阈值（FSV）低于传统组，肛管最大收缩压（MSP）高于传统组，差异有统计学意义（P<0.05）;STARR组C反应蛋白（CRP）、丙二醛（MDA）、白细胞介素-1β(IL-1β)、过氧化脂质（LPO）水平低于传统组，差异有统计学意义（P<0.05）;STARR组克利夫兰便秘（CCS）、Longo出口梗阻综合征（Longo ODS）评分低于传统组，差异有统计学意义（P<0.05）;STARR组并发症发生率与传统组比较差异无统计学意义（P>0.05）。结论 STARR能提高ODC患者直肠组织TMEM16A、Piezo1/2的表达水平，改善肛门直肠动力学与便秘情况，降低应激炎症反应。更多还原

【Abstract】 Objective To investigate the effects of transanal stapler rectal resection(STARR) on calcium-activated chloroponin 1(TMEM16A), mechanically sensitive ion channel protein(Piezo) 1, and Piezo2 in rectal tissues of outlet obstructive constipation(ODC). Methods Total of 110 patients with ODC were admitted to Cangzhou Central Hospital from January 2019 to June 2023. They were selected and divided into the traditional group(n=55) which received traditional surgery, and the STARR group(n=55) which underwent STARR procedure. The groups were determined using the random number table method. The levels of TMEM16A, Piezo1, and Piezo 2, anorectal dynamic indicators, stress-inflammatory indicators, constipation conditions, and complications were compared between the two groups. Results After treatment, the levels of TMEM16A, Piezo1, and Piezo 2 in the STARR group were higher than those in the traditional group, with statistical significance(P<0.05). Additionally, the maximum rectal tolerance volume(MTV), anal resting pressure(ARP), and initial sensory threshold(FSV) in the STARR group were lower than those in the control group, while the maximum anal systolic pressure(MSP) was higher than that in the traditional group, with statistical significance(P<0.05). The levels of C-reactive protein(CRP), malondialdehyde(MDA), interleukin-1β(IL-1β), and lipid peroxide(LPO) in the STARR group were significantly lower compared to those in the traditional group, with statistical significance(P<0.05). The scores of Cleveland Constipation Score(CCS) and Longo Outlet Obstruction Syndrome(Longo ODS) in the STARR group were significantly lower than those in the control group, with statistical significance(P<0.05). There was no statistically significant difference in the incidence of complications between the STARR group and the traditional group(P>0.05). Conclusion STARR can increase the expressions of TMEM16A and Piezo1/2 in the rectal tissues of patients with ODC. This can improve anorectal dynamics and constipation, as well as reduce the stress-induced inflammatory response.更多还原