痔上黏膜环切术对痔血流影响的临床研究  

Effects of procedure for prolapse and hemorrhoids on local blood flow

作　　者：陈艳妮[1] 柳东[2] 夏柏 薛雅红[4] 江滨[4] 

机构地区：[1]东南大学附属中大医院肛肠科,南京430022 [2]东南大学附属中大医院普外科,南京430022 [3]东南大学附属中大医院超声科,南京430022 [4]南京市中医院肛肠中心

出　　处：《临床外科杂志》2016年第1期56-58,共3页Journal of Clinical Surgery

摘　　要：目的通过直肠腔内彩色多普勒超声从血流动力学角度对痔上黏膜环切术(PPH)是否能阻断直肠上动脉(SAR)的终末分支进行观察。方法符合纳入标准的环状脱垂的Ⅲ、Ⅳ度内痔患者60例,行PPH(PPH组),健康对照组20例,通过直肠腔内彩色多普勒超声检测SAR终末分支的血管口径和血流速度,观察患者PPH术前、术后4周、3个月SAR终末分支的血管口径及血流速度,了解PPH手术对直肠上动脉血供的影响,以及手术疗效与直肠上动脉血供变化之间的关系。结果 PPH组与健康对照组术前SAR终末分支的口径及血流速度比较差异有统计学意义(P=0.032,<0.05)。PPH组术前、术后4周及术后3个月SAR终末分支的口径及血流速度比较差异无统计学意义(P=0.431,0.228>0.05)。结论 PPH术后不能使肛垫组织的血供降至正常,目前理论上推断其可阻断痔血供的治疗作用机制有待商榷。Objective To investigate the effects of the procedure for prolapse and hemorrhoids （PPH） on blocking the terminal branches of the superior rectal artery （SRA） by detecting the blood flow using non - invasive trans - anal Doppler ultrasound （CDUS）. Methods Sixty patients with grade III or IV internal hemorrhoids were enrolled for PPH. Twenty healthy volunteers served as the controls. By CDUS,arterial caliber （AC） and arterial flow velocity （AFV） of the terminal branches of the superior rectal artery were measured and compared before the operation, on the 4th weeks after the operation, and on the 3rd months after operation. Result The differences in AC and AVF between the patients and healthy controls were significant （P = 0. 032, 〈 0.05 ）. Postoperative follow-up showed no significant alterations in these parameters of patients （P = 0. 431,0. 228 〉 0.05 ）. Conclusion PPH can not decrease the vessel flow of the anorectal vascular plexus. Whether PPH can block the vessel flow of hemorrhoid re- main to be proved.

关 键 词：痔上黏环切术 多普勒超声 终末分支的血管口径 血流速度 

分 类 号：R657.18[医药卫生—外科学]