采用国产吻合器及分次双荷包缝合的痔上黏膜环切术治疗重度痔的疗效  

Clinical effect of a procedure for prolapse and hemorrhoids using a domestic stapler and a two-step double purse-string suture on the treatment of severe hemorrhoids

作　　者：向威[1] 苏波[1] 徐长青[1] 汪树利[1] 

机构地区：[1]四川省仁寿县人民医院普外二科,仁寿620500

出　　处：《新医学》2015年第7期458-461,共4页Journal of New Medicine

摘　　要：目的 探讨采用国产吻合器及改良荷包缝合法（分次双荷包缝合）的改良痔上黏膜环切术（PPH）治疗Ⅲ-Ⅳ期重度痔的疗效。方法 将120例Ⅲ-Ⅳ期重度痔患者随机分为分次双荷包缝合组、单荷包缝合组、1次性双荷包缝合组各40例,比较3组的手术时间、术中出血量、黏膜环切除宽度、黏膜环均匀程度、术后并发症等手术指标,并比较手术总体疗效。结果 总体比较结果显示,3组的术中出血量（F=13.299,P〈0.001）、黏膜环切除宽度（F=42.015,P〈0.001）、黏膜环均匀程度（χ^2=6.104,P=0.047）、总体疗效（χ^2=7.222,P=0.027）比较差异均有统计学意义（P均〈0.05）。两两比较结果显示,分次双荷包缝合组术中出血量、黏膜环宽度、黏膜环均匀程度、治愈率均优于另外2组（P均〈0.017）。结论 采用国产吻合器及分次双荷包缝合的PPH治疗Ⅲ~Ⅳ期重度痔疗效较好。Objective To investigate the clinical effect of a modified procedure for prolapse and hemorrhoids （PPH） using a domestic stapler and a two-step double purse-string suture （PSS） on the treatment of severe hemorrhoids （stage Ⅲ-Ⅳ）. Methods A total of 120 patients with stage Ⅲ-Ⅳ hemorrhoids were randomly and equally divided into three groups, including a two-step double PSS group, a single PSS group, and a one-step double PSS group （ n = 40 each）. Surgical indices, including the operation time, intraoperative blood loss, width and uniformity of the excisional mueosal stoma ring, and postoperative complications, were compared between the three groups. The overall effect of the PPH procedure was evaluated by comparative analysis. Results A comparison between the three groups of patients showed statistically significant differences （P 〈 0. 05 ） in the intraoperative blood loss （ F = 13. 299, P 〈 0. 001 ）, width of the excisional mucosal stoma ring （F = 42. 015, P 〈 0. 001 ）, uniformity of the exeisional mueosal stoma ring （χ^2 = 6. 104, P = 0. 047） , and overall effect （χ^2 = 7. 222, P = 0. 027 ）. Pairwise comparisons revealed that the two-step double PSS group achieved better outcomes than the other two groups in terms of the intraoperative blood loss, width and uniformity of the excisional mucosal stoma ring, and cure rate （ P 〈 0. 017 ）. Conclusion The modified PPH procedure using a domestic stapler and a two-step double PPS is effective for the clinical treatment of stage m-iV hemorrhoids.

关 键 词：痔上黏膜环切 国产吻合器 痔 临床效果 

分 类 号：R657.18[医药卫生—外科学]