痔上黏膜环型切除术和外剥内扎术治疗重度痔疮疗效观察  

Comparative on PPH and MMH in treating severe hemorrhoids

作　　者：赵敏[1] 王振军[2] 许艳春[3] 

机构地区：[1]首都医科大学全科医学与继续教育学院/延庆医院普外科,北京102100 [2]首都医科大学附属北京朝阳医院普通外科,北京100020 [3]中国人民解放军第251医院,河北张家口075000

出　　处：《长春中医药大学学报》2015年第3期615-617,共3页Journal of Changchun University of Chinese Medicine

基　　金：北京军区医疗成果项目(2009229)

摘　　要：目的探讨痔上黏膜环型切除术(PPH)与外剥内扎术(MMH)治疗重度(Ⅲ、Ⅳ度)痔疮的临床疗效。方法选取Ⅲ、Ⅳ度痔疮患者152例,依据治疗术式不同分为PPH组和MMH组,分别采用PPH术及MMH术治疗,对比2组术中、术后情况及疼痛视觉模拟(VAS)评分。结果 PPH组手术时间、术中出血量、住院时间显著低于MMH组(P<0.05);PPH组术后疼痛、尿潴留、肛门下坠感、便后出血及肛门狭窄发生率均显著低于MMH组(P<0.01);PPH组术后3、7 d切口肿胀评分、VAS评分均优于MMH组(P<0.05)。结论PPH术治疗重度痔疮手术用时短、术中出血少,术后疼痛轻且并发症发生率低。Objective To explore the clinical efficacy of procedure for prolapse and hemorrhoids （PPH） and Milligan-mor- gan hemorrhoids （MMH） in treating severe hemorrhoids （Ⅲ andⅣ degree）. Methods A total of 152 patients suffered fromⅢ and Ⅳ degree of hemorrhoids divided into the PPH group and MMH group according to the different treating meth- ods. The patients in the two groups were treated with PPH and MMH, respectively. The conditions during operation and after operation,and visual analogue scale （VAS） score in the two groups were compared. Results The operation time,amount of bleeding during operation, and hospitalization duration in the PPH group were significantly lower than those in the control group （ P 〈 0.05）. The occurrence rates of postoperative pain, urinary retention, bearing down, bleeding after stool, and anal stenosis in the PPH group were significantly lower than those in the control group （ P 〈 0.01 ）. The incision swelling score and VAS score 3 and 7 days after operation in the PPH group were significantly superior to those in the MMH group （ P 〈 0.05）. Conclusion PPH in treating severe hemorrhoids with the advantages of shorter operative time, less blood loss, slight postoperative pain, and low occurrence rate of complications, is an effective method to treat severe hemorrhoids.

关 键 词：痔上黏膜环型切除术 外剥内扎术 吻合器 痔疮 

分 类 号：R266[医药卫生—中医外科学]