直针手缝痔固定术初步研究(附140例报告)  

Straight Needle Hand-sewing Hemorrhoidopexy:A report of 140 cases

作　　者：徐加鹤[1] 金夏兰 单丽霞[3] 林才照[1] 李炎东[1] 王金海[1] 周喜乐[1] 华汉巨[1] 

机构地区：[1]浙江大学医学院附属第一医院肛肠外科,浙江省杭州市310003 [2]杭州市临安锦城医院肛肠外科 [3]浙江大学医院肛肠外科

出　　处：《中国全科医学》2008年第11期983-985,共3页Chinese General Practice

摘　　要：目的介绍一种治疗Ⅲ～Ⅳ度痔的新技术——直针手缝痔固定术,观察其临床效果。方法2005年9月—2007年10月采用直针手缝痔固定术治疗Ⅲ～Ⅳ度痔患者140例,对其临床效果进行分析。结果Ⅲ度痔66例,Ⅳ度痔74例。症状以出血为主10例（7.1%）,脱垂为主21例（15.0%）,出血脱垂兼有109例（77.8%）。术后疼痛用视比尺（0～10）记分,手术当天平均记分仅（1.83±1.76）分。术后无严重并发症。平均住院时间（5.5±2.4）d,平均住院费用（3168±1499）元。随访时间（1～25）个月,中位时间12个月,出血症状痊愈＋好转的比率为100%,脱垂症状痊愈＋好转率的比率为91.8%。恢复术前正常活动的时间为（0～30）d,中位时间9d。患者对手术非常满意和还满意的比率为94.5%。结论多中心非随机对比试验的初步结果显示,直针手缝痔固定术是安全、有效、痛苦小、经济、恢复快、满意度高的治疗Ⅲ～Ⅳ度痔的新方法。Objective To introduce a new technique,straight needle hand-sewing hemorrhoidopexy for 3-4 degreed hemorrhoids and to observe its clinical effect.Methods The clinical effects of 140 patients with 3-4 degreed hemorrhoids who underwent straight needle hand-sewing hemorrhoidopexy from September 2005 to October 2007 were reviewed and analyzed.Results There were 66 cases of 3 degreed hemorrhoids and 74 cases of 4 degreed hemorrhoids.There were 10（7.1%）cases with bleeding as the main symptom,,21（15.0%）cases with prolapse as the main symptom and 109（77.8%）cases with both symptoms,Visual analog scale（0-10）was used for assessment of postoperative pain,the mean score for the peak pain was （1.83±1.76）.No serious complications occurred postoperatively.The average hospitalization time was （5.5±2.44） days.The average costs of hospitalization was （3 168±1 499） RMB yuan.The median follow-up time was 12 （range,1-25） months.released or improved rate for symptom of bleeding was 100 %,and released or improved rate for symptom of prolapse was 91.8 %.The median duration of returning to normal activity was 9 （range,0-30） days.Some 94.5 % of the patients held that their operations were very good or good.Conclusion The results of this multi-centric nonrandom controlled pilot study shows that the straight needle hand-sewing hemorrhoidopexy is a new technique for 3-4 degreed hemorrhoids,which is safe,effective,painless,cheaper,faster in recovery,and with high degree of satisfaction.

关 键 词：痔 疼痛 痔上黏膜环切术 

分 类 号：R657.18[医药卫生—外科学]