外痔切剥辅助PPH术治疗混合痔的临床研究  

Clinical study of PPH plus external dissection in the treatment of mixed hemorrhoids

作　　者：杨向东[1] 贺平[1] 龚文敬[1] 黄德铨[2] 肖飏[3] 

机构地区：[1]成都肛肠专科医院,四川成都610015 [2]四川省中医院 [3]成都市第三人民医院

出　　处：《结直肠肛门外科》2010年第3期140-145,共6页Journal of Colorectal & Anal Surgery

摘　　要：目的观察和评价外痔切剥辅助PPH术治疗混合痔临床疗效。方法采用前瞻性、多中心、随机、对照的研究方法 ,将216例混合痔患者随机分为A组和B组,分别采用外痔切剥辅助PPH术和外剥内扎术,并在术后1d、术后3d、术后1周及术后3个月对便血的情况、肛门疼痛、肛门或会阴坠胀、肛门不适、肿物突出、肛门潮湿、肛门瘙痒根据疗效评分标准进行评价。结果 A组在手术时间、恢复工作时间、创口愈合时间上明显好于B组,且经统计学检验,差异有统计学意义(P<0.05)。术后1d肛门疼痛、肛门潮湿、肿物突出、大便情况、便血情况指标评分A组明显低于B组,经统计学检验,差异有统计学意义(P<0.05);术后1d肛门瘙痒、肛门不适、肛门坠胀指标评分A组与B组比较经统计学检验,组间差异无统计学意义(P>0.05)。术后3d肛门疼痛、肛门潮湿、肿物突出、便血情况指标评分A组明显低于B组,经统计学检验,差异有统计学意义(P<0.05);术后3d大便情况、肛门不适、肛门瘙痒、肛门坠胀指标评分A组与B组比较经统计学检验,组间差异无统计学意义(P>0.05)。术后1周肛门疼痛、肛门潮湿、肿物突出、便血情况、肛门不适、肛门坠胀指标评分A组明显低于B组,经统计学检验,差异有统计学意义(P<0.05);术后1周大便情况、肛门瘙痒指标评分A组与B组比较经统计学检验,组间差异无统计学意义(P>0.05)。术后3个月肿物突出、便血情况指标评分A组明显低于B组,经统计学检验,差异有统计学意义(P<0.05);术后3个月肛门疼痛、肛门潮湿、大便情况、肛门不适、肛门瘙痒、肛门坠胀等指标评分A组与B组比较经统计学检验,组间差异无统计学意义(P>0.05)。术后3个月复发率A组明显低于B组,经统计学检验,差异有统计学意义(P<0.05)。结论外痔切剥辅助PPH术治疗混合痔肛门功能损伤小,疼痛轻微,术后并发症少,恢复快,术后�Objective To evaluate the clinical efficacy of the procedure for prolapse and hemorrhoids （PPH） plus external dissection in the treatment of mixed hemorrhoids.Methods In this prospective,multicenter,randomized,control study,216 patients with mixed hemorrhoids were randomly divided into group A and group B.Group A was treated by PPH plus external dissection and group B by external dissection and internal ligation procedure.Results The operation time,recovery time,wound healing time in Group A was significantly shorter than that in group B （P0.05）.One day after operation,index score of anal pain,anal wetness,mass prolapse,defecation,hematochezia in group A was significantly lower than that in group B （P0.05）.Three days after operation,index score of defecation,anal discomfort,anal itch,rectal fullness in group A was significantly lower than that in group B （P0.05）.One week after operation,index score of anal pain,anal wetness,mass prolapse,hematochezia,anal discomfort,rectal fullness in group A was significantly lower than that in group B （P0.05）.Three months after operation,index score of mass prolapse,hematochezia in group A was significantly lower than that in group B （P0.05）.The postoperative recurrence rate after three months in group A was significantly lower than in group B （P0.05）.Conclusion PPH plus external dissection is a simple,easily performed procedure with quick recovery,less postoperative complications and recurrence for mixed hemorrhoids

关 键 词：外痔切剥 PPH术 混合痔 

分 类 号：R657.1[医药卫生—外科学]