痔上黏膜环切并选择性外剥内扎术治疗Ⅲ～Ⅳ度痔疗效观察  

Observation of the effect of procedure for prolapse and hemorrhoids and selective Milligan-Morgan hemorrhoidectomy in surgical treatment of Ⅲ ～ Ⅳ stage hemorrhoids

作　　者：杨填[1] 曾永明[1] 王怀明[1] 李威[1] 

机构地区：[1]汕头大学医学院第一附属医院胃肠外科, 广东省汕头515041

出　　处：《中国基层医药》2014年第1期1-3,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 比较痔上黏膜环切术（PPH）、PPH＋选择性痔核外剥内扎术（MMH）治疗Ⅲ～Ⅳ度痔的临床效果,探讨治疗Ⅲ～Ⅳ度痔的最佳术式.方法 回顾性分析125例Ⅲ～Ⅳ度痔经手术治疗患者的临床资料,非随机对照分为PPH治疗组（1组）、PPH＋选择性痔核MMH治疗组（2组）,分别采用PPH术式和PPH＋选择性痔核MMH术式治疗,观察术后复发率、并发症和肛门坠胀感、出血、肿块脱出、肛门瘙痒、肛门潮湿等症状缓解情况.结果 术后观察3年,两组均明显缓解了脱垂、便血及肛门下坠感、肛门潮湿、肛门瘙痒等症状,缓解率均达92%以上.1组术后复发8例,复发率13%；2组术后复发1例,复发率2%,两组复发率差异有统计学意义（X2=4.629,P＜0.05）.结论 应首选PPH＋选择性痔核MMH术式治疗Ⅲ～Ⅳ度痔,既能最大程度减少痔症状,又取得更好的远期治疗效果.Objective To compare the clinical outcome of procedure for prolapse and hemorrhoids （PPH） and PPH ＋ selective Milligan-Morgan hemorrhoidectomy（MMH） in surgical treatment of Ⅲ ～ Ⅳ stage hemorrhoids and research the best surgical procedures.Methods Retrospective analysis was made on the clinical data of 125 cases with Ⅲ ～ Ⅳ stage mixed hemorrhoids,they were non-randomized-controlled divided into PPH group （group 1） and PPH ＋ selective MMH group（group 2）,comparing the data of recurrence,complication and symptoms relief including anal prolapse,bleeding,anus fall feeling,wet anus and pruritus ani.Results While observing 3 years after operation,group 1 and group 2 both relieved symptoms of anal prolapse,bleeding,anus fall feeling,wet anus and pruritus ani.The relief rate of these symptoms in the two group were all high than 92%.There was one cases relapsed in the group 2 （the recurrence rate of 2%） was better than the group 1 （the recurrence rate of 13%） which were 8 case,there was a significant statistical significance （x2 =4.629,P 〈 0.05） in the recurrence and clinical outcome.Conclusion Radical choose of PPH and selective MMH to treat Ⅲ ～ Ⅳ stage mixed hemorrhoids patients,which could relieve postoperative symptoms and acquire better long-term clinic outcomes.

关 键 词：痔 环状混合痔 吻合器痔上黏膜环切术 外剥内扎痔切除术 

分 类 号：R657.18[医药卫生—外科学]