吻合器痔上黏膜环切订合术联合聚桂醇硬化剂注射治疗重度痔:86例疗效分析  

Clinical Effect on Procedure for Prolapse and Hemorrhoids Combined with Sclerotherapy of Lauromacrogol Injection for Severe Hemorrhoids: 86 Cases Reports

作　　者：雷庆军[1] 张毅强[1] 王益[1] 贺向东 LEI Qing-jun ZHANG Yi-qiang WANG Yi HE Xiang-dong(Department of General Surgery, the First People ＇s Hospital of Taicang, Taicang 215400, Jiangsu, China Department of Colorectal Surgery, Traditional Chinese Hospital of Xi ＇an, Xi ＇an 710021, Shaanxi , China)

机构地区：[1]江苏省太仓市第一人民医院胃肠外科,太仓215400 [2]陕西省西安市中医医院肛肠外科,西安710021

出　　处：《中国现代手术学杂志》2017年第1期22-26,共5页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨吻合器痔上黏膜环切订合术(procedure for prolapse and hemorrhoids,PPH术)联合聚桂醇硬化剂注射治疗重度痔的临床疗效。方法将170例重度痔(Ⅲ、Ⅳ期)患者按入院顺序随机分为两组:治疗组86例,采用PPH术加聚桂醇硬化剂注射治疗;对照组84例,采用传统外剥内扎术加聚桂醇硬化剂注射治疗。比较两组患者手术情况、临床治疗效果及术后并发症。结果治疗组平均手术时间和平均住院时间分别为(23.25±3.41)min和(5.20±0.94)d,对照组分别为(60.11±4.85)min和(12.57±1.52)d,组间比较均有统计学差异,治疗组均明显优于对照组(P<0.05)。两组总体疗效评价,治疗组内痔脱垂及出血症状有效率分别为95.3%和96.5%,高于对照组的85.7%和88.1%,差异有统计学意义(P<0.05)。治疗组术后疼痛、肛缘水肿、排尿困难等并发症均少于对照组(P<0.05),两组术后排便异常情况比较差异无统计学意义(P>0.05)。术后20 d及6个月后随访,两组无一例发生肛门狭窄。结论 PPH术加聚桂醇硬化剂注射治疗重度痔操作简便,对肛门功能损伤小,疗效确切,值得临床推广。Objective To explore the clinical efficacy of procedure for prolapse and hemorrhoids （PPH） combined with sclerotherapy of lauromacrogol injection for treatment of severe hemorrhoids. Methods A total of 170 cases with severe hemorrhoids （ m or IV stage） were randomized into two groups： The treatment group （ n = 86） were treated by PPH combined with sclerotherapy lauromaerogol injection, and the control group （ n = 84） were performed the Milligan-Morgan haemorrhoideetomy combined with sclerotherapy of lauromacrogol injection. The peri-operative outcomes, clinical effect and postoperative complication were compared between two groups. Results The average operative duration and hospital stays was （23.25 ± 3.41 ） min and （ 5.20 ± 0.94 ） d respectively in the treatment group, and was （ 60.11 ± 4.85 ） rain and （ 12.57 ± 1.52 ） d respectively in the control group. There was statistical difference in operative duration and hospital stays between two groups, the treatment group was better （ P 〈 0.05 ）. The total resuh revealed the effective rate of the treatment group was 95.3% and 96.5% in prolapse symptom and hemorrhage symptom, both were higher than 85.7% and 88.1% of the control group （ P 〈 0.05 ）. The postoperative complication of anal pain, anal-edge edema and dysuria was less in the treatment group than those in the control group （P 〈 0.05 ）, but there was no statistical difference in abnormal defecation between two groups （P 〉 0.05）. No anal stenosis was found during follow-up in both groups. Conclusion The treatment of PPH combined with sclerotherapy of lauromacrogol injection is an effective therapy for severe hemorrhoids with less damage of the anal function, reliable effect and simple operating.

关 键 词：痔 吻合器痔上黏膜环切术 硬化疗法 聚桂醇 MILLIGAN-MORGAN术 

分 类 号：R657.18[医药卫生—外科学]