RPH联合简化外切内扎术治疗混合痔多中心随机对照研究  

Treatment of Mixed Hemorrhoids by RPH with the Simplified Mil igan-Morgan Surgery: a Multi-center,Randomized,Controlled Clinical Trial

作　　者：何永恒[1] 唐智军[2] 许向彤[3] 黄德铨[4] 张理顺 唐清珠[6] 樊志敏[7] 邹贤君 邹国军[9] 张重阳[10] 胡凡[1] 谢彪[1] 李艳华[2] 佟瑶[3] 刘鸿畅[4] 李可[5] 罗育连[6] 刘飞[7] 司徒光伟 刘作龙[9] 邵秋香[10] 

机构地区：[1]湖南中医药大学第二附属医院肛肠科,长沙410005 [2]湖南中医药大学附属常德医院肛肠科,湖南415000 [3]南京中医药大学附属徐州医院肛肠科,江苏221000 [4]成都中医药大学附属医院肛肠科,成都610081 [5]湖南中医药大学附属长沙医院肛肠科,长沙410199 [6]南方医科大学附属郴州医院中医肛肠科,湖南423099 [7]南京中医药大学第三附属医院肛肠科,南京210000 [8]武汉市第八医院中医肛肠科,武汉430010 [9]湖南中医药大学附属岳阳医院肛肠科,湖南414000 [10]河北省沧州中西医结合医院外五科,湖北061000

出　　处：《中国中西医结合杂志》2017年第4期422-425,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：湖南省中医药科研计划资助项目(No.201503);湖南省教育厅重点学科中医外科学开放基金项目(No.zywk-kf)

摘　　要：目的选择性自动结扎疗法(RPH)联合简化外切内扎术治疗混合痔的安全性和有效性。方法选择1 200例混合痔患者,按照随机、平行对照、多中心试验设计方法分为对照组和治疗组,每组600例,对照组采用痔上黏膜环切吻合术(procedure for prolapse and hemorrhoids,PPH)加简化外切内扎术,治疗组采用RPH+简化外切内扎术。观察患者术后并发症、手术时间、术后住院时间及术后随访疗效。结果与对照组比较,治疗组术后大出血、尿潴留、继发性肛裂和肛门直肠狭窄例数减少(P<0.01,P<0.05),手术时间和术后住院时间减少(P<0.01,P<0.05),术后3、12个月痊愈率升高(P<0.01)。结论 RPH联合简化外切内扎术治疗混合痔可以减少术后并发症,提高临床痊愈率和疗效。Objective To observe the safety and efficacy of RPH with the simplified Milligan-Mor- gan（M-M） surgery on mixed hemorrhoids. Methods Totally 1 200 patients with mixed hemorrhoid were assigned to the control group（600 cases） and the treatment group（600 cases） according to randomized,parallel controlled,multi-center trial design. Patients in the control group received PPH with the simplified M-M surgery, and patients in the treatment group received RPH with the simplified M-M surgery. Postop- erative complications, operation time,the postoperative hospitalization days and the efficacy were ob- served. Results Compared with the control group, the numbers of postoperation hemorrhage, postop- erative uroschesis, anal fissure and anorectal stenosis in treatment group were decreased （P 〈0.01, P 〈 0.05）, operation time and the postoperative hospitalization days were decreased （P 〈0.01, P 〈0.05）, the cure rate for 3 and 12 months after operation were increased （P 〈 0.01, P 〈 0.05 ）. Conclusions RPH with the simplified M-M surgery could reduce the incidence of postoperative complications ,improve the clinical cure rate and the curative effect in treatment of mixed hemorrhoids.

关 键 词：混合痔 选择性自动结扎疗法 肛肠手术 随机对照研究 

分 类 号：R657.18[医药卫生—外科学]