痔动脉结扎、围扎悬吊术对痔出血及脱垂后并发症的预防效果  

Effect of hemorrhoid artery ligation and surrounded suture and suspension in prevention of complications after hemorrhage and prolapse of hemorrhoids

作　　者：李忠海 

机构地区：[1]滦平县医院普外科,河北滦平068250

出　　处：《结直肠肛门外科》2016年第1期34-37,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的研究痔动脉结扎、围扎悬吊术对痔出血及脱垂后并发症的预防效果。方法选取我院2014年2月至2015年6月肛肠外科收治的78例脱垂性（Ⅲ~IV度）痔病患者,随机分为对照组和观察组,各39例。对照组患者给予传统外剥内扎术治疗,观察组患者采用痔动脉结扎加痔本体围扎悬吊术治疗。比较两组手术疗效、手术及住院基本指标（手术时间、术中出血量、住院时间、创口愈合时间）和术后不同时点视觉疼痛模拟评分（VAS）,观察两组术后患者出血和并发症发生情况,随访6个月观察复发情况。结果观察组手术有效率100.00%、随访6个月复发率2.78%分别较对照组97.44%、5.41%无显著差异（P〈0.05）;但观察组手术出血量（9.6±3.1）m L、创口愈合时间（6.1±2.2）d分别较对照组（12.1±4.2）m L、（9.5±3.4）d低,差异显著（P〈0.05）;观察组术后6h VAS（3.5±1.2）分、18h（2.7±0.9）分分别较对照组（4.3±1.5）分、（3.6±1.4）分低,差异显著（P〈0.05）;观察组术后并发症15.38%较对照组35.90%低,差异显著（P〈0.05）。结论痔动脉结扎加围扎悬吊术不仅具有同传统外剥内扎术相近的手术疗效,而且能有效减少脱垂性痔病患者术中出血量、减轻患者疼痛,对促进创口愈合和减少脱垂后并发症效果较好。Objective To study the effect of hemorrhoid artery ligation and surrounded suture and suspension in prevention of complications after hemorrhage and prolapse of hemorrhoids. Methods 78 cases of patients with prolapsed hemorrhoids（III-IV level） who were treated in the Department of Anal-colorectal Surgery of our hospital between February 2014 and June 2015 were selected and randomized into the control group and observation group, 39 cases in each group. Patients in the control group were treated with traditional Milligan-Morgan hemorrhoidectomy while patients in the observation group were treated with hemorrhoid artery ligation combined with surrounded suture and suspension. The curative effect, basic indexes of operation and hospitalization（operation time, intraoperative bleeding volume, hospitalization time, wound healing time） and pain visual analogue scores（VAS） at different time points after operation were compared between the two groups. The situation of postoperative hemorrhage and incidence of complications in the two groups were observed. With 6 months of follow-up, the status of recurrence was observed. Results The effective rate of operation and the recurrence rate during 6 months of follow-up in the observation group（100.00%, 2.78%） were not significantly different from those in the control group（97.44%, 5.41%）（P〈0.05）; P〈0.05 However, the intraoperative bleeding volume（9.6±3.1） ml and wound healing time（6.1±2.2） d of the observation group was respectively less and shorter than that of the control group [（12.1±4.2） ml,（9.5±3.4） d]（P〈0.05）; The VAS scores of the observation group at postoperative 6h and 18 h [（3.5±1.2）,（2.7±0.9）] were significantly lower than those of the control group [（4.3±1.5）,（3.6±1.4）]（P〈0.05）; The incidence of postoperative complications in the observation group（15.38%） was lower than that in the control group（35.90%）（P〈0.05）. Conclusion Hemorrhoid artery ligation and surrounded suture an

关 键 词：痔出血 脱垂 痔动脉结扎 围扎悬吊术 

分 类 号：R657.18[医药卫生—外科学]