PPH与外剥内扎术联合治疗重度混合痔的前瞻性研究  

A Prospective Study on the Combined Therapy of PPH plus External Dissection ＆ Internal Ligation in the Treatment of Severe Mixed Hemorrhoids

作　　者：杜金林[1] 金晰函[1] 张天明[1] 戴志慧[1] 钟志凤[1] 

机构地区：[1]浙江省金华市中心医院肛肠外科,浙江金华321000

出　　处：《中国肛肠病杂志》2012年第3期15-17,共3页Chinese Journal of Coloproctology

摘　　要：为探讨PPH与外剥内扎术联合治疗重度混合痔的疗效，采用前瞻性对比研究的方法，将443例重度混合痔患者分为3组：实验组140例采用PPH联合外剥内扎术治疗，对照1组153例采用单纯PPH治疗，对照2组150例采用外剥内扎术治疗。观察3组患者术后半年疗效积分。结果显示，在肛门疼痛、总的疗效积分方面，实验组均优于对照1组和对照2组；肛门肿物脱垂实验组优于对照1组（P〈0．01）；排他带血实验组优于对照2组（P〈0．01）。术后住院期间，实验组术后疼痛明显轻于对照2组（P〈0．05）；与对照l组无显著性差异（P〉0．05）；术后排便次数增多，实验组与对照1组相似（P〉0．05），但优于对照2组（P〈0．05）。实验组术后复发率为2．9％，均明显低于对照1组和对照2组。结果表明，PPH与外剥内扎术联合治疗重度混合痔，手术效果好，术后并发症少，恢复快，肛门功能损伤小，术后复发率低，患者满意度高，操作方法简单，易于掌握和推广。Four hundreds and fourty three patients with severe mixed hemorrhoids（SMH） were divided into 3 groups. Patients in the study group（ n = 140） underwent PPH plus external dissection ＆ internal ligation（PPH plus EDIL）,patients in the control group I （ n = 153） underwent PPH,and patients in the control group Ⅱ （ n = 150） underwent external dissection ^- internal ligation（EDIL）. Which observe the patients postoperative therapeutic efficacy scores in 6 months. As results,the study group was better in terms of anal pain reduction and therapeutic efficacy scores than control group Ⅰ and Ⅱ;better in retraction of prolapsed matters than control group I （ P 〈0. 01） ;better in reduction of bloody stool than control group ]I （ P d0.01） ;During postoperative in hospital,the study group is better in terms of the postoperative pain reduction than control group Ⅱ （ P 〈0.05） and has no statistics difference with control group Ⅱ（ P 〈0.05） . the postoperative stool frequency is increase of which study group is similar to control group I （ P 〈0.05） and better than that cantrol group Ⅱ （ P 〈0.05）,the recurrence rate in the study group was 2. 9%,less than that in the control groupⅠ and Ⅱ. It is concluded that the combined therapy of PPH plus EDIL has many strong points such as better therapeutic efficacy,less complications,more rapid recovery, less injury of the anus function, less recurrence, higher satisfaction of patients, simple manipulation and popularize, etc.

关 键 词：痔 吻合器痔上黏膜环切术 外剥内扎术 

分 类 号：R657.18[医药卫生—外科学]