PPH治疗Ⅲ、Ⅳ度混合痔52例分析  

Application of the Procedure for Prolapse and Hemorrhoid in the Treatment of Mixed Hemorrhoids of Ⅲ、Ⅳ Degrees： Analysis of 52 cases

作　　者：陈雅文[1] 韦智经 

机构地区：[1]广东省广州市荔湾区第二人民医院普外科,广东广州510160

出　　处：《中国肛肠病杂志》2008年第8期15-16,共2页Chinese Journal of Coloproctology

摘　　要：对52例行PPH的Ⅲ、Ⅳ度混合痔病例并发症及治疗效果进行探讨。结果显示，PPH术后出血和痔块萎缩可能与荷包缝线结扎的血管部位、深度、数量有关；部分患者术后肛门失禁可能与32mm扩肛器直径仍然过大有关。结果表明，对于单发的Ⅲ度内痔可以选用痔或痔上黏膜套扎术，Ⅲ度的混合痔可以选用DG-HAL；Ⅲ、Ⅳ度单纯的内痔宜选用PPH；Ⅲ、Ⅳ度肛垫增大、下移、脱垂较明显的宜选用痔切闭术。各种术式最佳效果的部位似乎都是在齿状线上2cm处。The therapeutic results of 52 patients with mixed hemorrhoid of Ⅲ、Ⅳ degrees,who had undergone the procedure of prolapse and hemorrhoid（PPH） ,were analized. It is believed that bleeding and hemorrhoidal atrophy after PPH may probably be related to the location, depth and number of ligation of blood vessel,and that postoperative defaecation incontinence may be related to the improperly bigger diameter of anus dilator（32 mm）. It is suggested that the procedure of rubber band ligation is suitable for simple internal hemorrhoid of Ⅲ degrees,DG-HAL is suitable for mixed hemorrhoids of Ⅲ degrees,PPH is suitable for simple internal hemorrhoids of Ⅲ and Ⅳ degrees,and the procedure of excision-closed hemorrhoidectomy is suitable for Ⅲ、Ⅳ-degree hemorrhoids with enlarged anus cusion and severely prolapsed or lower-shifted hemorrhoids. It is also suggested that the best location for all procedures is situated at 2 cm above the dental line.

关 键 词：痔 并发症 吻合器痔上黏膜环切术 

分 类 号：R657.18[医药卫生—外科学] R684.7[医药卫生—临床医学]