保存肛垫双齿形切扎术治疗嵌顿环状混合痔  

Double Denenate Excision - Ligation Combinedwith Pad Preservation for the Treatment ofIncarcerated Annular Mixed Hemorrhoids

作　　者：吕谭发[1] 陈浩洋[1] 张悦[1] 

机构地区：[1]广东省深圳市中医院,深圳518033

出　　处：《广州中医药大学学报》2004年第6期433-435,438,共4页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局资助课题(编号:102017)

摘　　要：[目的]探讨治疗嵌顿环状混合痔的新术式。[方法]保存肛垫双齿形切扎术治疗嵌顿环状混合痔118例,外剥内扎治疗53例作为对照组,对比观察两组治愈率、创面愈合时间、肛门功能、术后并发症等指标。[结果]治疗组的治愈率为96.6％.对照组为84.9％..治疗组的创面愈合时间为(17±5)d,对照组为(24±5)d(t=10.58,P<0.01)。肛管静息压测定结果:治疗组术前(11.7 ±2.1)kPa,术后(6.9±2.0)kPa(t=17.83,P<0.01);对照组术前(11.6±2.0)kPa,术后(9.6 ±1.9)kPa(t=4.97,P<0.01)。治疗组未出现肛门狭窄,对照组见4例(7.5％)出现不同程度肛门狭窄。水肿发生率:治疗组为4.2％,对照组为13.2% (P<0.05)。术后24 h排尿困难的发生率:治疗组为10.2％,对照组为22.6％(P<0.05)。[结论]保存肛垫双齿形切扎术治疗嵌顿环状混合痔可提高治愈率,缩短创面愈合时间,保存肛门正常生理功能,减少术后并发症。[Objective] To search for a new technique for incarcerated annular mixed hemorrhoids (IAMH) . [Methods] One hundred and eighteen cases of IAMH (group A) were treated by double denenate excision-ligation combined with pad preservation and 53 eases (group B) by external-exfoliation and internal-ligation. Cure rate, wound-healing time, anal function and postoperative complications were observed in the two groups. [Results] Cure rate was 96.6% in group A and 84.9% in group B; wound-healing time was (17 ± 5) days in group A and (24 ± 5) days in group B ( P < 0.01) . Anal canal static pressure was ( 11 .7 ± 2.1) kPa before operation and (6.9 ± 2.0) kPa after operation in group A ( t = 17.83, P < 0.01); anal canal static pressure was (11.6 ± 2.0) kPa before operation and (9.6 ± 1.9) kPa after operation in group E (t = 4.97, P < 0.01). No case with stricture of anus was found in group A while 4 (7.5%) cases with different degrees of stricture were found in group B. The incidence of edema was 4.2% in group A and 13.2% in group B ( P < 0.05) and incidence of dysuria was 10.2% in group A and 22.6% in group B ( P < 0.05) 24 hours after operation. [Conclusion] Double denenate excision-ligation combined with pad preservation can increase cure rate, shorten wound-healing time, improve anal function and reduce the incidence of postoperative complications in the treatment of IAMH.

关 键 词：肛垫 双齿形切扎术 环状混合痔 齿线 

分 类 号：R657.18[医药卫生—外科学]