分段分离外切内扎术治疗环状混合痔嵌顿临床探讨  

Clinical Observation of the Effect of Segmented Resection of the External and Separated Ligation of the Internal Hemorrhoids in the Treatment of Incarcerated Circumferential Mixed Hemorrhoids

作　　者：张伟[1] 

机构地区：[1]上海交通大学附属上海市第一人民医院分院中痔科,上海200031

出　　处：《中外医疗》2016年第4期10-12,18,共4页China & Foreign Medical Treatment

摘　　要：目的探讨以分段分离外切内扎急症手术治疗环状混合痔嵌顿的临床应用价值。方法整群选取2012年2月—2014年8月间初次住院手术的84例环状混合痔嵌顿患者,连续进入观察。随机分成两组：治疗组（分段分离外切内扎急症手术组）42例,对照组（保守治疗1-2周后择期手术组）42例,根据疗效、术后症状积分、术后不良反应、住院时间、治疗费用及安全性等方面的结果做出评价。结果治疗组治愈率为97.62%,对照组治愈率为95.24%,二者差异无统计学意义。在术后症状积分上,治疗组的便血发生较对照组减少,术后疼痛较对照组有所减轻,水肿、坠胀、痔核脱落时间、创面愈合时间两组差异无统计学意义。但治疗组因无需前期治疗,总住院时间及治疗费用大大减少。结论环状混合痔嵌顿施行急症手术切实可行,安全可靠。且可缩短疗程,使患者尽快恢复工作、生活,减少医疗费用,对人体无不良影响,不影响肛门功能。Objective To discuss the clinical application effect of segmented resection of the external and separated ligation of the internal hemorrhoids in the treatment of incarcerated circumferential mixed hemorrhoids. Methods We executed a continuous observation for 84 incarcerated circumferential mixed hemorrhoids patients who hospitalized and underwent surgery as the first time from February 2012 to August 2014. We split them to 2 groups randomly, the curing group（42patients） treated by segmented resection of the external and separated ligation of the internal hemorrhoids as the emergency operation and the control group（42 patients） treated by elective operation after the conservative treatment of 1-2 weeks. We evaluated the results based on the therapeutic efficacy, the grading of postsurgical symptoms, the postsurgical side effects,the cure period, medical expense and the margin of safety. Results The curing ratio of the curing group is 97.62%, there is no statistical significance from 95.24%, which is the curing ratio of the control group. In terms of the grading of postsurgical symptoms： Comparing with the control group, the curing group has a lower incidence of hematochezia, and less pain. But there is no statistical significance on edema, anus bugles and haemorrhoids dropping off time between the two groups. The wound surface fusing periods are not obviously differences yet. And the overall length of stay and medical expense of the curing group was much less because of no prophrase treatment. Conclusion It＇s executable and safe to use segmented resection of the external and separated ligation of the internal hemorrhoids as the emergency operation for incarcerated circumferential mixed hemorrhoids. It will decrease the duration of therapy, reduce the medical expense and help the patients to go back to normal life and workplace as soon as possible. This method has no negative effects on the human body, also has no negative effects on the function of anus.

关 键 词：环状混合痔嵌顿 分段分离外切内扎术 急症手术 

分 类 号：R657.18[医药卫生—外科学]