抗凝治疗的内痔患者行吻合器痔上黏膜环切术的治疗体会  

Clinical experience for prolapse and hemorrhoids in treatment of hemorrhoids in anticoagulated patients

作　　者：侯辉[1] 余智涛[1] 王悦辉[1] 

机构地区：[1]梅州市人民医院肛肠外科,广东梅州514031

出　　处：《岭南现代临床外科》2014年第3期317-320,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨吻合器痔上黏膜环切术（PPH）治疗接受抗凝剂治疗的内痔患者的安全性和临床疗效。方法2009年1月～2011年12月我们对36例由于患有心血管疾病长期接受抗凝剂治疗患者（抗凝组）和49例未接受抗凝治疗（对照组）的内痔患者施行PPH术。比较两组患者的手术时间、住院时间、术中和术后出血、肛门疼痛、肛门狭窄、肛门失禁、住院期间心脑血管疾病的发生率。结果抗凝组和对照组患者术中出血量分别为15．8±1．9mL和29．8±3．4mL（t=22．7，P〈0．05），出血较多分别抗凝组有1例（2．8％）、对照组有2例（4．1％），3例患者估计出血量约200～500mL，给予正确处理措施后彻底止血，无一例输血；术后无一例发生心脑血管疾病意外。手术时间、术后并发症和住院时间等比较无明显差别（P〉0．05）。结论对于接受抗凝治疗的内痔患者,PPH手术的疗效与安全性均与正常接受PPH手术患者无明显差别。Objective To evaluate the efficacy and safety of surgical procedure for prolapse and hemorrhoids （PPH） in patients treating with anticoagulant （anticoagulated group）. Methods From Jan 2009 to Dec 2011,36 patients with cardiovascular diseases treated with anticoagulant and 49 patients without anticoagulated therapy （control group） were included in this study. All patients underwent procedure for prolapse and hemorrhoids. A comparison was done between the two groups in terms of the following items： operation time, intraoperative and postoperative blood loss and the incidence of cardiovascular and cerebrovascular diseases, postoperative cure rate of prolapse and bleeding, significant postoperative anal pain,incontinence, anal stenosis, and hospital stay. Results All patients were cured. The differences between the anticoagulated group and control group were significant in terms of and postoperative blood loss（P〈0.05）, and no significant differences were noted in other items. Postoperative hemorrhage with a volume of 200ml to 500 ml happened in one case in anticoagulated group and 2 cases in control group, and were cured by conservative treatment. No case needed blood transfusion. Conclusion It is safe and effective for patients with cardiovascular diseases treated with anticoagulant.

关 键 词：吻合器痔上黏膜环切术 抗凝治疗 内痔 

分 类 号：R657.18[医药卫生—外科学]