吻合器痔上黏膜环切钉合术与开放式外剥内扎痔切除术治疗Ⅲ度痔远期疗效比较  

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

作　　者：朱军[1] 丁健华[1] 赵克[1] 汤海燕[1] 赵勇[1] 张斌[1] 赵玉涓[1] 刘胜男[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：《中国实用外科杂志》2012年第5期398-402,共5页Chinese Journal of Practical Surgery

摘　　要：目的比较吻合器痔上黏膜环切钉合术(PPH)与开放式外剥内扎痔切除术(MMH)对Ⅲ度痔的远期疗效。方法第二炮兵总医院肛肠外科对2001年5月至2004年5月间因Ⅲ度痔行PPH的78例和MMH的86例病人进行随访,比较两组病人术后症状缓解情况、并发症和复发情况。结果 PPH和MMH均明显缓解了脱垂(93.6%vs.95.3%)、便血(95.2%vs.92.5%)及肛门下坠感(92.4%vs.94.3%)等症状,两组比较差异无统计学意义(P>0.05)。PPH组术后肛门潮湿、肛门瘙痒的缓解率优于MMH组(P<0.05)。PPH和MMH对不同类型及脱垂程度痔的缓解率比较,差异均无统计学意义(P>0.05)。两组术后总体并发症发生率(12.8%vs.11.6%)、复发率(10.3%vs.10.5%)及满意度(86.3vs.84.2)比较,差异也无统计学意义(P>0.05)。结论 PPH治疗Ⅲ度痔的远期疗效及安全性与MMH相同。Objective To compare the long-term results of procedure for prolapse and hemorrhoids （PPH） and Milligan-Morgan hemorrhoidectomy （MMH） in the treatment of m degree hemorrhoids. Methods Seventy-eight patients in PPH group and 86 patients in MMH group treated from May 2001 to May 2004 in Department of Colorectal Surgery, the Second Artillery General Hospital of PLA were followed up. All the patients suffered with HI degree hemorrhoids. The data including symptoms relief, complication and recurrence were compared between two groups. Results PPH and MMH both relieved prolapse （93.6% vs. 95.3%）, bleeding （95.2% vs. 92.5%） and anus fall feeling （92.4% vs. 94.3%） significantly. There were no significant differences between two groups （P〉0.05）. PPH relieved wet anus and pruritus ani more significantly compared with MMH （P〈0.05）. No significant difference of complete relief rates between PPH group and MMH group according to different types and prolapses of hemorrhoids was found （P〉0.05） There was no significant difference in the overall complication rate （12.8% vs. 11.6%）, recurrence rates （10.3% vs. 10.5% ） and satisfactory degree （86.3 vs. 84.2） between two groups as well （P〉0.05）. Conclusion The long-term outcomes of PPH in the treatment of m degree hemorrhoids are similar to Milligan-Morgan hemorrhoidectomy.

关 键 词：痔 吻合器痔上黏膜环切钉合术 开放式外剥内扎痔切除术 

分 类 号：R6[医药卫生—外科学]