吻合器痔上黏膜环切术联合Ligasure痔切除术治疗重度混合痔的疗效观察  

Efficacies of procedure for prolapse and hemorrhoids plus Ligasure in the treatment of severe hemorrhoids: a comparative study

作　　者：李国文 曾山崎[2] 陈转鹏[2] 李莉珊 罗文辉 王成兴[2] 杨平[2] 张伟健[2] 

机构地区：[1]广东省从化市街口街社区卫生服务中心外科,510900 [2]广州医科大学附属广州市第一人民医院

出　　处：《中华临床医师杂志（电子版）》2014年第1期44-47,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：广州市县级市及乡镇医疗卫生单位新技术新项目推广应用项目(2008-XZL-05)

摘　　要：目的探讨吻合器痔上黏膜环切术(PPH)联合Ligasure痔切除术治疗重度混合痔疗效。方法将2011年1月1日至2012年12月31日收治的80例混合痔(Ⅲ、Ⅳ度)患者按随机数字表法随机分为试验组和对照组,每组40例,试验组实施PPH术联合Ligasure痔切除术,对照组实施PPH+痔核缝扎术,比较两组疗效。结果试验组手术时间[(35.62±11.50)min vs.(52.58±14.86)min]、术中出血量[(21.89±7.14)ml vs.(48.65±12.80)ml]、术后疼痛持续时间[(1.89±1.02)d vs.(4.29±1.35)d]及住院时间[(4.71±1.69)d vs.(6.16±2.20)d]明显优于对照组,便中带血[(7.30±2.72)ml vs.(10.44±6.41)ml]、肛缘水肿时间[(2.80±1.27)d vs.(7.19±3.54)d]、创面愈合时间[(5.08±1.69)d vs.(8.46±3.07)d]明显优于对照组,差异均有统计学意义(P<0.05)。结论 PPH术联合Ligasure痔切除术是一种安全有效的治疗重度混合痔的方法,值得在临床上推广。Objective To investigate the efficacy of PPH combined with Ligasure in the treatment of severe hemorrhoids. Methods According to the random number table, patients with grade Ⅲ and Ⅳhemorrhoids were randomly divided into two groups, the experimental group （by PPH＋Ligasure） 40 cases and the control group （by PPH＋ligation） 40 cases. The operation time, intraoperative blood loss, duration of pain at the first postoperative defecation, duration of the postoperative pain, hospital stay and postoperative complications （including postoperative blood in the feces, edema of anal edge, the wound healing time, postoperative urinary retention, anal secretion matter, anal stenosis rate and the rate of wound infection） of two groups were recorded and analyzed. Results There were statistical differences in the terms of operative time, intraoperative blood loss, duration of pain at the first postoperative defecation, duration of the postoperative pain, hospital stays, postoperative blood in the feces, edema of anal edge and the wound healing time, experiment group is much better than that of the control group （P〈0.05）;However, there were no statistical differences in the terms of postoperative urinary retention, anal secretion matter, anal stenosis rate and the rate of wound infection between the two groups （P〉0.05）. Conclusion Compared with the traditional surgery, PPH combined Ligasure in the treatment of severe hemorrhoids has more advantages, such as less bleeding, shorter operative time, postoperative pain, shorter hospitalization time.

关 键 词：吻合器痔上黏膜环切术 Ligasure痔切除术 痔核缝扎术 重度混合痔 

分 类 号：R657.18[医药卫生—外科学]