三种不同手术方式治疗重度混合痔的疗效及对患者生存质量的影响  

Comparison on Efficacies of Three Different Procedures for Severe Mixed Hemorrhoids and Their Influences on Patients＇ Quality of Life

作　　者：黄如华[1] 陈峰[1] 郑玉金[1] 邓正明[1] 林巧媚[1] 

机构地区：[1]福建省福州市第一医院肛肠科,福建福州350009

出　　处：《中国肛肠病杂志》2016年第8期29-32,共4页Chinese Journal of Coloproctology

基　　金：福州市卫生局科技计划项目（2013-S-W1）

摘　　要：为比较3种不同手术方式治疗重度混合痔的疗效，以及对患者生存质量的影响，将150例重度混合痔患者随机分为3组，各50例，分别行外剥内扎术、吻合器痔上黏膜环切术（PPH）、超声多普勒引导下痔动脉结扎术（DG—HAL）治疗，对比观察3组患者术后肛门疼痛、出血、肛缘水肿、肛门功能等情况，以及患者术前、术后2周的生存质量。生存质量采用生存质量测定简表（WHOQOL-BREF）评估。结果显示，PPH组和DG-HAL组肛门疼痛、出血、肛缘水肿、肛门功能方面均优于外剥内扎术组，P〈0．01或P〈0．05。外剥内扎术组、DG-HAL组肛门坠胀情况方面优于PPH组，P〈0．05。术后生存质量各方面评分比较发现，PPH组和DG-HAL组在生理领域方面明显优于外剥内扎术组，P〈0．01；心理、社会、环境领域方面比较，3组间均无统计学意义，P〉0．05。结果表明，PPH及DG-HAL在减轻重度混合痔患者术后肛门疼痛、出血、肛缘水肿及提高生存质量方面优于外剥内扎术，DG-HAL在减轻肛门坠胀方面优于PPH。This study was to compare the efficaeies of three different procedures for severe mixed hemorrhoids and their influences on patients＇ quality of life; divided 150 cases of severe mixed hemorrhoids into three groups,50 cases for each, performed external dissection ＆ internal ligation, procedure for prolapsed and hemorrhoids （PPH） and Doppler guided hemorrhoid artery ligation （DG-HAL） respectively on the 3 groups;compared such status of three groups as anal pain,bleeding,anal edge edema, anal function after operation and the life quality of two weeks before and after operation. The life quality was assessed by WHOQOL-BREF.As results, in anal pain, bleeding,anal edge edema, anal function, PPH group and DG- HAL group were all superior to traditional external dissection ＆ internal ligation （ P 〈0,01 or P 〈0.05）. In tenesmus of anus,external dissection ＆internal ligation group and DG-HAL group were all superior to PPH group（ P 〈0.05）.The comparison of score in all aspects of life quality after operation found that in physiological field,PPH group and DG-HAL group were all superior to the external dissection and internal ligation group （ P 〈0.01）.Compared in psychological, social and environment field, there was no statistic significance among three groups （ P 〈0.05）.In conclusion,in reducing anal pain,bleeding,anal edge edema and improving life quality after the operation of severe mixed hemorrhoids,PPH and DG-HAL are all superior to the external dissection and internal ligation;in relieving the tenesmus of anus,DG-HAL is superior to PPH.

关 键 词：重度混合痔 外剥内扎术 吻合器痔上黏膜环切术 超声多普勒引导下痔动脉结扎术 生存质量 

分 类 号：R734.2[医药卫生—肿瘤]