吻合器痔核环切术治疗环状混合痔的临床研究  

Effects of Circular Stapled Hemorrhoidectomy on Circumferential Mixed Hemorrhoids

作　　者：叶云奎[1] 蔡锚[1] 金纯[1] 徐永强[1] 胡万乐[1] 卢敏[1] 郑晨果[1] 严煌 

机构地区：[1]温州医科大学第二附属医院肛肠外科,浙江温州325027

出　　处：《中国肛肠病杂志》2015年第10期27-29,共3页Chinese Journal of Coloproctology

摘　　要：为探讨吻合器痔核环切术（CSH）治疗环状混合痔的近、远期疗效及安全性，对2012年1月至2013年9月于我院肛肠外科住院的290例环状混合痔患者采用CSH治疗，即应用痔吻合器做双荷包，第一个荷包做在齿状线处，第二个荷包做在齿状线上方1～1．5cm的直肠黏膜处，手术切除痔核及直肠下端的黏膜，将远端留下的肛垫同近端直肠黏膜吻合。手术同时完成了痔的切除、悬吊、固定及血流阻断。结果显示，本组290例手术全部成功。术后并发症：疼痛218例（75，17％），肛门下坠感75例（25．86％），轻度肛门失禁52例（17．93％），上述并发症在1周左右逐渐好转。术后随访15～36个月，成功随访240例（82．76％），复发3例（1.25％）（痔脱出程度较术前明显减轻），I度排便失禁1例，不影响正常生活。结果表明，CSH治疗环状混合痔手术操作简单、近远期疗效良好，安全性高，是可行的手术方式。This study was to explore the long-term and short-term effects of circular stapled hemorrhoidec- tomy on circumferential mixed hemorrhoids. A total of 290 patients with this hemorrhoids were treated with circular stapled hemorrhoidectomy（CSH）.PPH03 hemorrhoidal circular stapler was used and double purse-strlng sutures were ap above the dentate line） inclu most rectal mucosa, and the plied（one was on the same level with the dentate line, the other was 1-1.5cm ding the mucosa and submucosa.The procedure resected hemorrhoids and end- anal cushions left on the edge of the anal canal were anastomosed with lower rectal mucosa.The procedure completed the removal of hemorrhoids, suspension, fixation, and blood flow blocking. As results, the 290 cases were performed smoothly. Postoperative complications included pain （218/290,75.17G）,anal tenesmus （75/290,25.86%）, and minor fecal incontinence （52/290,17.93%）. Condition above-mentioned improved about one week later. The follow-up period was 15-36 months, and success follow-up rate was 82.7%（240/290）.Follow-up results., recurrence occurred in 3 cases （1.25X, compared with the preoperative condition,degree of hemorrhoid prolapse reduced significantly）.I degree of fecal incontinence in 1 case did not affect normal life. In conclusion, circular stapled hemorrhoidectomy is easy to complete,and it has good long-term and short-term effects,and high safety,and it＇s a feasible proce- dure in the treatment of prolapsed circumferential mixed hemorrhoids.

关 键 词：痔 吻合器痔核环切术 齿状线 肛垫 

分 类 号：R657.18[医药卫生—外科学]