痔上黏膜环切钉合术与Milligan—Morgan术治疗Ⅲ、Ⅳ度内痔2年疗效比较  

Comparison of two-year efficacy between procedure for prolapse and hemorrhoids and Milligan-Morgan hemorrhoidectomy in treatment of Ⅲ and Ⅳ degree internal hemorrhoids

作　　者：高瑞忠[1] 梁小波[2] 许长年[3] 张金燕[3] 王平[1] 牛海刚[1] 

机构地区：[1]山西医科大学汾阳学院外科教研室,032200 [2]山西省肿瘤医院肛肠外科 [3]山西医科大学附属汾阳医院普通外科

出　　处：《中华胃肠外科杂志》2008年第3期249-252,共4页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的比较痔上黏膜环切钉合术（PPH）与Milligan—Morgan术（MMH）治疗Ⅲ、Ⅳ度内痔的远期疗效。方法按照完全随机分组原则将100例Ⅲ、Ⅳ度内痔患者分别采用PPH（PPH组，42例）和MMH（MMH组，58例）手术，观察并比较两组患者术后的远期疗效差异。结果PPH组与MMH组术后2年比较，在出现肛门溢液（2．38％比20．69％，P=0．007）、皮赘（9．52％比25．86％，P=0．040）和细便（2．38％比18．97％，P=0．027）方面PPH组术后少见，总的并发症发生率（9．52％比25．86％，P=0．040）和总排便功能异常（9．52％比29．31％，P=0．017）方面PPH组术后也少见，两组差异有统计学意义。在痔脱垂复发（14．29％比10．34％，P=0．549）、症状改善满意度（92．86％比87．93％，P=0．636）和总的症状复发（19．05％比25．86％，P=0．424）方面两组差异无统计学意义。结论PPH与Milligan-Morgan术治疗Ⅲ、Ⅳ度内痔的远期疗效无显著差异，但PPH安全、并发症少、对排便功能影响小。Objective To compare the long-term efficacy of procedure for prolapse and hemorrhoids （PPH） and Milligan-Morgan hemorrhoidectomy （MMH） in the treatment of Ⅲ and Ⅳ degree internal hemorrhoids. Methods One hundred patients were randomly divided into two groups and received PPH （n=42） and MMH （n=58） respectively. After two years, the efficacy, complications and function of defecation were compared. Results Two years after operation, the morbidities of hydrorrhea （2.38% vs 20.69%, P=0.007）, dermal neoplasm formation （9.52% vs 25.86%, P= 0.040） and narrowing in the caliber of the stools （2.38% vs 18.97%, P=0.027） were significantly lower in PPH group than those in MMH group （P〈0.05）. The morbidities of overall complication （9.52% vs 25.86%, P=0.040） and overall abnormal function of defecation （9.52% vs 29.31%, P= 0.017） were lower in PPH group than those in MMH group （P〈0.05）. However, there were no significant differences of the morbidity of relapse （14.29% vs 10.34%, P=0.549）, patient satisfactory degree （92.86% vs 87.93%, P=0.636） and overall symptom recurrence rate （19.05% vs 25.86%, P=0.424） between the two groups. Conclusions Long-term efficacies of procedure for prolapse and hemorrhoids and Milligan-Morgan haemorrhoidectomy in the treatment of Ⅲ and Ⅳ degree internal hemorrhoids are similar. PPH has better safety, less complications and less effect on abnormal function of defecation compared with MMH.

关 键 词：痔 痔上黏膜环切钉合术 Milligan—Morgan术 治疗效果 

分 类 号：R657.18[医药卫生—外科学]