吻合器痔上粘膜环切术与外剥内扎术治疗Ⅲ、Ⅳ度内痔的疗效比较  

COMPARISON OF PROCEDURE FOR PROLAPSE AND HEMORRHOIDS VERSUS MILLIGAN-MORGAN HEMORRHOIDECTOMY FOR Ⅲ AND Ⅳ DEGREE INTERNAL HEMORRHOIDS

作　　者：陈喜志 王运红 蓝活 

机构地区：[1]深圳市龙岗区沙湾人民医院,广东深圳518114

出　　处：《现代医院》2014年第5期24-26,共3页Modern Hospitals

基　　金：广东省医学科研基金(编号:B2012171)

摘　　要：目的比较吻合器痔上粘膜环切术与外剥内扎术治疗Ⅲ、Ⅳ度内痔的疗效。方法将2007年1月~2009年7月间符合纳入标准的80例患者随机分为两组,分别采用PPH术式（PPH组,42例）和MMH术式（MMH组,38例）,评价并比较两组患者围术期及术后3年的疗效。结果 PPH组的手术时间及住院时间均显著少于MMH组（p〈0.05）,而两组在患者满意度方面并无统计学差异（p〉0.05）。PPH组术后24 h的疼痛情况显著优于MMH组（p=0.033）,而在远期并发症和复发方面两组并无统计学差异（p〉0.05）。PPH组在总的排便异常（p=0.020）和细便（p=0.023）方面优于MMH组,而在其余方面并无统计学差异（p〉0.05）。结论吻合器痔上粘膜环切术与外剥内扎术治疗Ⅲ、Ⅳ度内痔的远期疗效无显著差异,但PPH术疼痛轻微、恢复快,且远期的排便功能优于MMH术。Objective The aim of this study was to compare the results of procedure for prolapse and hemorrhoids and Milligan- Morgan hemorrhoidectomy for the management of Ⅲ and Ⅳ degree internal hemorrhoids. Methods 80 cases met the inclusion criteria during January 2007 to July 2009 were randomize to PPH group（ 42 cases）and MMH group（ 38 cases）. Perioperative and 3 years- postoperative clinical effects were evaluated and compared.Results The operative time and hospital stays of PPH group were significantly less than MMH group（ p 0. 05）.There were no significant difference between the two groups in satisfaction（ p 0. 05）. PPH group was superior to MMH group in postoperative- 24- hours pain（ p = 0. 033）. However,there were no statistical difference in long-term complications and recurrence between the two groups（ p 0. 05）. Besides,there were significant difference between the two groups in general abnormal defecation（ p = 0. 020） and narrowing stools（ p = 0. 023）,nevertheless,no statistical difference were found in other aspects（ p 0. 05）. Conclusion The clinical effects of procedure for prolapse and hemorrhoids and Milligan- Morgan hemorrhoidectomy in treatment of Ⅲ and Ⅳ degree internal hemorrhoids were comparable. Furthermore,PPH had mild pain,fast recovery and better defecation compared with MMH.

关 键 词：痔 吻合器痔上粘膜环切术 外剥内扎术 

分 类 号：R657.18[医药卫生—外科学]