吻合器痔上黏膜环切钉合术与Milligan—Morgan术治疗重度痔远期疗效比较  

Comparison of long-term efficacy on severe hemorrhoids between procedure for prolapse and hemorrhoids and Milligan-Morgan hemorrhoidectomy

作　　者：丁健华[1] 赵克[1] 蒋仁秀[1] 朱军[1] 尹淑慧[1] 孔玉珍[1] 汤海燕[1] 

机构地区：[1]第二炮兵总医院肛肠外科全军肛肠病专病中心,北京100088

出　　处：《中华胃肠外科杂志》2009年第4期382-385,共4页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的比较吻合器痔上黏膜环切钉合术（PPH）与Milligan-Morgan（MM）术对重度痔的远期疗效。方法对2001年5月至2005年5月问因Ⅲ度、Ⅳ度痔行PPH的91例和MM术的102例患者进行随访，比较两组患者术后症状缓解情况、治愈情况和并发症及复发情况。结果PPH和MM术均明显缓解了便血（95．6％比92．7％）、疼痛（93．1％比94．3％）、脱垂（93．4％比93．1％）等症状，两组比较，差异无统计学意义（P〉0．05）。PPH组术后排便困难的缓解率优于MM术组（60．O％比32．1％，P〈0．05）。PPH和MM术对不同分度、类型及脱垂程度痔的治愈率比较．差异均无统计学意义（P〉0．05）。两组术后总体并发症发生率（14．3％比12．7％）、复发率（12．1％比8．8％）及满意度（85．1V888．2）比较，差异也无统计学意义（P〉0．05）。结论PPH治疗Ⅲ度、Ⅳ度痔的远期疗效及安全性与MM术相同。Objective To compare the long-term results of procedure for prolapse and hemorrhoids （PPH） and Milligan-Morgan （MM） hemorrhoidectomy in the treatment of third- and fourth-degree hemorrhoids. Methods Ninety-one patients in PPH group and 120 patients in MM group, treated in our hospital from May 2001 to May 2005, were followedup. All the patients suffered with third- or fourth-degree hemorrhoids. The data including symptoms relief, complication and recurrence were compared between two groups. Results PPH and MM both significantly relieved bleeding （95.6% vs 92.7% ）, pain （93.1% vs 94.3% ） and prolapse （93.4% vs 93.1% ）. There were no significant differences between two groups （P〉0.05）. PPH significantly relieved constipation compared with MM （60.0% vs 32.1%, P〈0.05）. No significant differences of complete relief rates between PPH group and MM group according to different degrees, types and prolapses of hemorrhoids were found （P〉0.05）. There were no significant differences in the overall complication rate （14.3% vs 12.7%）, recurrence rates（12.1% vs 8.8%） and satisfactory degree （85.1 vs 88.2） between two groups as well. Conclusion The long-term outcomes of PPH in the treatment of third and fourth-degree hemorrhoids are similar to Milligan-Morgan hemorrhoidectomy.

关 键 词：痔 吻合器痔上黏膜环切钉合术 Milligan—Morgan手术 

分 类 号：R657[医药卫生—外科学]