吻合器痔上黏膜环切术治疗Ⅲ、Ⅳ期环状内痔疗效分析  

Procedure for prolapsed hemorrhoids treatment for III, IV hemorrhoids efficacy

作　　者：缪剑辉[1] 马炯[1] 丁红岩[1] 袁保[1] 

机构地区：[1]江苏省江阴市中医院肛肠科,江阴214400

出　　处：《国际外科学杂志》2012年第12期816-819,共4页International Journal of Surgery

基　　金：江苏省汀阴市农业、社会、生物科技、软课题及社发指导项目基金资助项目（No.20100743）

摘　　要：目的探讨吻合器痔上黏膜环切术治疗Ⅲ、Ⅳ期环状内痔的远期临床疗效。方法回顾性分析87例行吻合器痔上黏膜环切术的Ⅲ、Ⅳ期环状内痔患者的临床资料，其中Ⅲ期环状内痔65例，Ⅳ期环状内痔22例，中位随访时间为（3．8±0．5）年，观察术后远期疗效及并发症的发生情况，并对Ⅲ期与Ⅳ期环状内痔远期疗效及并发症应用卡方检验作对比分析。结果Ⅲ期环状内痔再次大便出血2例（3．1％），出现肛门坠胀4例（6．2％）；Ⅳ期环状内痔再次肛门肿物脱出2例（9．1％），大便出血5例（22．7％），出现肛门坠胀3例（13．6％），排便困难1例（4．5％），I度肌门失禁1例（4．5％），未出现肛门疼痛、肛门狭窄、异物不适及急便感等并发症。运用卡方检验作对比分析显示：Ⅲ期环状内痔术后脱出与出血的复发率明显低于Ⅳ期环状内痔术后。结论吻合器痔上黏膜环切术治疗环状内痔是安全可行的，具有创伤小、疼痛轻、疗效确切、并发症少、住院时间短、再手术率低等优点，但远期疗效Ⅲ期环状内痔优于Ⅳ期环状内痔。Objective To investigate the consistent long-term clinical efficacy of the procedure for prolapsed hemorrhoids （ PPH ） treatment for hemorrhoids. Methods Data of 87 patients with third- and fourth- degree hemorrhoids treated by surgical procedure for prolapsed hemorrhoids were collected. In all cases, third-degree hemorrhoids in 65 cases, fourth-degree hemorrhoids in 22 cases, median followed up after PPH was （3.8 ± 0.5） years. The long-term efficacy and the occurrence of complications were followed up to assess the effect of surgical proce- dure for prolapsed hemorrhoids. Results In patients with third-degree hemorrhoids, bleeding recurred in 2 cases （3.1%） for again bleeding, for anal bulge in 4 cases （6.2%）. In patients with fourth-degree hemorrhoids, pro- lapse recurred in 2 cases （9.1%） for bleeding in 5 cases （22.7%）. anal bulge 3 patients （ 13.6% ） ,defecation difficult in one case （4.5%） ,one-degree of fecal incontinence in 1 case （4.5%） , no other complications found, such as anal pain, anal stenosis, foreign body discomfort and fecal urgency. The chi-square test for comparison analysis suggested that： third-degree hemorrhoids postoperative prolapse and bleeding recurrence rate was significantly lower than fourth-degree hemorrhoids. Conclusions Procedure for prolapsed hemorrhoids treatment for hemorrhoids is safe and feasible, has small trauma, little pain, and definite efficacy, fewer complications, shorter hospital stay, lower reoperation rate, etc. But the long-term efficacy for third-degree hemorrhoids is superior to the fourth- degree hemorrhoids.

关 键 词：痔 手术后并发症 治疗结果 吻合器痔上黏膜环切术 

分 类 号：R657.18[医药卫生—外科学]