不同术式治疗环状混合痔的临床疗效观察及其成本效果分析  

Clinical Effect Observation and Cost-effectiveness Analysis on Different Operation Types of Ring Mixed Hemorrhoids Treatment

作　　者：李俊[1] 李亚玲[1] 闻永[1] 岳朝驰[1] 

机构地区：[1]泸州医学院附属医院,泸州646000

出　　处：《世界科学技术-中医药现代化》2014年第4期762-768,共7页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：泸州医学院校级科研项目(11043):热疗贴在PPH术中的应用;负责人:李俊

摘　　要：目的：对比研究不同术式吻合器痔上粘膜环切术（PPH）与外剥内扎术（M-M）治疗环状混合痔的的临床疗效及安全性，并评价其卫生经济学效果。方法：回顾性分析泸州医学院附属医院2008年6月-2010年6月间行PPH术（P组48例）与M-M术（M组52例）符合纳入标准的100例患者的临床资料。对两组的近、远期疗效，患者满意度，术中、术后并发症进行统计分析，并运用卫生经济学方法分析其成本效果。结果：两组近期疗效无明显差异，但P组在手术时间、住院时间、恢复工作时间、疼痛持续时间、出血情况，术后疼痛、肛门水肿等方面明显优于M组（P〈0.05）；M组远期疗效及成本效果比明显优于P组（P〈0.05），两组不良反应发生率无明显差异。结论：传统外剥内扎术治疗环状混合痔有较好的近、远期临床疗效，成本效益好，仍是治疗环状混合痔的较佳术式。This study was aimed to compare clinical effect and safety of ring mixed hemorrhoids treatment with pro-cedure for prolapsed and hemorrhoids （PPH） and Milligan-Morgan （M-M） in order to evaluate their effects of health economics. Retrospective analysis was given on clinical data of 100 cases （including 48 cases in P group, 52 cases in M group） which met the inclusion criteria from June 2008 to June 2010 in the Affiliated Hospital of Luzhou Med-ical College. Statistical analysis was made on short- and long-term effect, patient satisfaction, perioperative and postoperative complications of two groups. The cost-effectiveness was analyzed with the effect of health economics methods. The results showed that there was no obvious difference on short-term effect between two groups. However, aspects such as surgery time, hospitalization time, back to work time, duration of pain, bleeding condition, postopera-tive pain and anal swelling in P group were significantly better than M group （P〈 0.05）; long-term effect and cost-effectiveness in M group were obviously better than P group （P 〈 0.05）. There was no obvious difference on inci-dence rate of adverse reaction between two groups. It was concluded that the traditional external dissection and inter-nal ligation for circumferential mixed hemorrhoids had better clinical effect of both short- and long-term with better cost-effectiveness. It is still a better surgical treatment for circular mixed hemorrhoids.

关 键 词：PPH术 M-M术 环状混合痔 疗效 成本效果分析 

分 类 号：R657.1[医药卫生—外科学]