Milligan-Morgan术式联合痔核套扎术治疗痔病的经验  

Effect of Milligan- morgan combined with Ruiyun procedure for hemorrhoids on treatment of hemorrhoids:Experience report

作　　者：陈展鹏 关振忠 

机构地区：[1]南海区第五人民医院普外科,广东佛山528231

出　　处：《岭南现代临床外科》2016年第6期698-702,共5页Lingnan Modern Clinics in Surgery

基　　金：广东省佛山市医学类科技攻关项目(No.0010029120409026)

摘　　要：目的介绍Milligan-Morgan术（M-M术）联合痔疮套扎术（M-M-R术）治疗痔病的经验和优势。方法选择2014年7月-2015年12月Ⅲ期-Ⅳ期痔病接受（M-M-R组）术治疗的患者91作为观察对象,另选择具有可比性的同期接受吻合器痔上黏膜环切术（PPH）78例作为对照（PPH组）,观察各组患者的术中情况、术后表现,并发症发生、住院费用、术后住院时间以及满意度等方面情况。结果 M-M-R和PPH术式的手术用时为（42.7±28.6）min和（28.5±5.3）min,两组相比较有统计学意义。两组手术出血量均小于10 m L。M-M-R组与PPH组在术后疼痛（VAS）、肛门坠涨感、肛缘水肿方面差异具有统计学意义,但上述表现均短期内恢复。M-M-R组最明显优势是费用明显少于PPH组（P〈0.05）。两组手术的满意度差异没有统计学意义。术后便血、排尿、术后住院时间以及满意度,直肠-肛管反射功能两组比较差异无统计学意义。随访3月,两组均为发生肛门狭窄、大便再出血、复发等情况。结论 M-M-R术式效果至少在短期内与PPH相当,术后肛门疼痛患者可以接受;由于治疗费用相对低廉,M-M-R术尤其适合于基层医院实施。Objective To investigate the effect of Milligan- morgan combined with Ruiyunprocedure on hemorrhoids and summarize the experience. Methods 169 patients with hemorrhoids wereincluded in the study from Jul. 2014 to Dec. 2015 in our hospital. Of them,91 cases were performedMilligan- morgan combined with Ruiyun procedure on hemorrhoids（M- M- R group）,and 78 casesunderwent procedure for prolapse and hemorrhoids（PPH group）. The operation duration,hemorrhage duringoperation,hospital charge,emergency,postoperative anal pain and edema,postoperative bleeding,postoperative inconvenience,and anorectal dynamics of post operation were observed,recorded andcompared between two groups. Results The operation time was 42.7±28.6 minand 28.5±15.3 min in M-M-Rgroup and PPH group,respectively（P〈0.05）. Intraoperative blood loss was less than 10 ml in each group.The patients in M-M-R group had higher visual analogue scale（VAS）than in PPH group. There were morepatients presented postoperative inconvenience in M-M-R group,including anal complaints,anal edema,mild fecal incontinence and those got recovery in a few days after operation. M-M-R group had the lowerhospital inpatient expenses than PPH group. There were no statistical significant differences in thepostoperative prolapse,bleeding,urination,and the satisfactory degree between two groups. There werenot archostenosis,stool bleeding,recurrence recorded in 3 months of follow-up. Conclusion The effectof M-M-R procedure was comparable with PPH on treatment of hemorrhoids at least in the short time.M-M-R is especially suitable for the implementation of the basic hospital due to its lower cost.

关 键 词：痔病 M-M术 PPH术 M-M-R术 

分 类 号：R657.18[医药卫生—外科学]