痔上黏膜环切钉合术治疗重度痔的临床观察  

Clinical application of PPH in treatment of severe hemorrhoids

作　　者：钱峻 黄学锋[2] 宋章法[2] 

机构地区：[1]新昌人民医院肛肠外科 [2]浙江大学医学院附属邵逸夫医院肛肠外科

出　　处：《全科医学临床与教育》2008年第1期14-16,共3页Clinical Education of General Practice

摘　　要：目的比较痔上黏膜环切钉合术(PPH)与传统Milligan-Morgan手术治疗重度痔(Ⅲ、Ⅳ度)的疗效。方法分别采用PPH手术(PPH组)和Milligan-Morgan法痔切除术(传统组)治疗重度痔各40例,比较手术时间、住院时间、术后疼痛、出血、术后尿潴留、恢复时间。结果PPH组手术时间为(29.45±6.91)min,传统组为(48.65±10.65)min;PPH组住院时间为(3.03±1.49)d,传统组为(6.10±2.51)d;PPH组恢复工作时间为(8.00±1.73)d,传统组为(19.78±10.60)d,三项组间差异均有统计学意义(t分别=17.81、11.40、12.48,P均<0.05)。PPH组术后疼痛轻,无1例肛门狭窄发生,二组差异均有统计学意义(χ2分别=11.52、11.40,P均<0.05)。PPH组和传统组术后出血发生率分别为5%和10%,术后尿潴留发生率分别为25%和30%,两组差异无统计学意义(χ2分别=0.52、0.18,P均>0.05)。结论PPH术具有安全、有效、住院时间短和恢复快等优点,对于合适的病人可替代传统的手术治疗方法。Objective To compare the effects of procedure for prolapse and hemorrhoids （PPH） with that of traditional hemorrhoidectomy in the treatment of severe hemorrhoids（grade Ⅲ or Ⅳ）. Methods Eighty patients with severe hemorrhoids were randomly divided into PPH group and the traditional Million-Morgen group. Each group has 40 patients. The operating time, hospitalization time, postoperative pain, bleeding, postoperative urinary retention, and recovery time in each group were compared. Results The operation time were （29.45±6.91）min and （48.65±10.65）min in the PPH and traditional group, respectively（t=17.81, P〈0.05）; hospitalization stay time was （3.03±1.49） days vs. （6.10±2,51） days （t=11.40, P〈0.05）; the recovery work time was （8.00±1.73） days vs. （19.78±10.60） days （t=12.48, P〈0.05）. PPH group patients had less postoperative pain and no anal stricture and had obvious differences with tranditional group （X2=11.52,11.40, P〈0.05）; there were no statistic differences in postoperative urinary retention and bleeding between the two groups（X^2=0.18,0.52, P〉0.05）. Conclusions PPH is a safe and effective treatment method for third or fourth degree hemorrhoids with the advantages of shorter time hospitalization and faster recovery.h could become an alternative for the conventional hemorrhoidectomy in proper patients.

关 键 词：痔 PPH 痔切除术 

分 类 号：R657.1[医药卫生—外科学]