外剥内扎注射术加括约肌松解术治疗急性嵌顿痔的疗效分析  

Effect of Milligan-Morgan Injection Technique Combined with Sphincter Lysis on Acute Incarcerated Hemorrhoid

作　　者：朱宝山 陈巍峰[2] 

机构地区：[1]黑龙江省大庆市第五医院肛肠外科,黑龙江大庆163714 [2]复旦大学附属中山医院普外科,上海200032

出　　处：《中国临床医学》2012年第6期640-641,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨外剥内扎注射术加括约肌松解术治疗急性嵌顿痔的疗效。方法:2007年1月至2011年6月手术治疗急性嵌顿痔患者360例,其中行外剥内扎注射术加括约肌松解术者180例(治疗组),行单纯外剥内扎注射术者180例(对照组)。比较两组患者手术时间、创面愈合时间、治愈率及术后切口疼痛、尿潴留、肛缘水肿、肛门狭窄等并发症的发生率,并随访嵌顿痔的复发情况。结果:治疗组手术时间平均为(27±5)min,对照组为(22±4)min,两组比较P<0.05;治疗组创面愈合时间平均为(17.5±2.1)d,对照组为(17.0±1.8)d,两组比较P>0.05。治疗组180例中,治愈174例,治愈率96.7%;对照组180例中,治愈163例,治愈率90.6%,两组比较P<0.05。术后随访1～3年,治疗组无便血、痔核脱出、肛门溢液等症状,复发率0%;对照组复发10例,复发率5.56%,两组比较P<0.05。治疗组患者术后切口疼痛、尿潴留、肛缘水肿和肛门狭窄等并发症的发生率均显著低于对照组。结论:采用外剥内扎注射术加括约肌松解术治疗急性嵌顿痔并发症少,近期疗效好。Objective：To investigate the effect of Milligan-Morgan injection in combination with sphincter lysis on acute incar- cerated hemorrhoid. Methods： A total of 360 patients with acute incarcerated hemorrhoid from January 2007 to June 2011 were enrolled. They were divided into two groups. The observation group（n = 180） received injection operation of outer stripping and inner ligation combined with sphincter lysis, while the control group（n = 180） only underwent injection operation of outer stripping and inner ligation. The rates of cut ache after operation, uroschesis, edema of anus and anus stenosis were compared between these two groups. Results： Univariate analysis demonstrated that the rates of cut ache after operation, uroschesis, e- dema of anus and anus stenosis were significantly lower in the observation group than those in the control group. During follow- up of one to three years, the observation group had no recurrence, while the contol group had hematochezia in six cases and thrombosed external hemorrhoids in 4 cases. Conclusions： Injection operation of outer stripping and inner ligation combined with sphincter lysis is a feasible, safe and effective methncl foracute incarcerated hemorrhoid.

关 键 词：嵌顿痔 外剥内扎注射术 括约肌松解术 疗效 

分 类 号：R657.18[医药卫生—外科学]