血栓剥除联合痔上黏膜环切钉合术治疗嵌顿性环状混合痔的疗效分析  

Thrombus removal of external hemorrhoid combined with procedure for prolapse and hemorrhoids in the treatment of incarcerated circumferential mixed hemorrhoids

作　　者：叶辉[1] 周启昌[1] 龚治林[1] 于杰[1] 黄淑娟[1] 郗昌磊 曹龙磊 钱群[2] 江从庆[2] Ye Hui Zhou Qichang Gong Zhilin Yu J ie Huang Shujuan Xi Changlei Cao Longlei Qian Qun Jiang Congqing(Department of Colorectal Surgery , J ingzhou Hospital, Tongj i Medical College of Huazhong University of Science and Technology, Jingzhou , Hubei 434020, China Department of Colorectal Surgery, Zhongnan Hospital of Wuhan University, Wuhan , Hubei 430071, China)

机构地区：[1]华中科技大学同济医学院附属荆州医院结直肠肛门外科,湖北荆州434020 [2]武汉大学中南医院结直肠肛门外科,武汉430071

出　　处：《重庆医学》2017年第14期1938-1940,共3页Chongqing medicine

摘　　要：目的观察血栓剥除联合痔上黏膜环切钉合术(PPH)对嵌顿性环状混合痔中的治疗效果。方法将118例嵌顿性环状混合痔患者分为两组,试验组60例,采用血栓剥除术联合PPH手术方法;对照组58例,采用外剥内扎术手术方法。观察两组患者术后视觉模拟评分法(VAS)评分,水肿、出血、皮赘残留例数,伤口愈合时间,肛门狭窄、肛门失禁例数,肛管直肠测压及满意度差异。结果试验组与对照组术后水肿、出血、皮赘残留例数比较差异有统计学意义(χ~2=6.63、4.19、6.64,P<0.05);术后肛门狭窄、肛门失禁例数比较差异无统计学意义(χ~2=0.38、1.11,P>0.05)。试验组与对照组术后VAS评分、愈合时间、满意程度、肛管静息压、肛管最大收缩压比较差异有统计学意义(P<0.01)。结论血栓剥除联合PPH术后并发症少,恢复快,对肛门功能影响小。Objective To observe the clinical effect of thrombus removal of external hemorrhoid combined with procedure for prolapse and hemorrhoids（PPH） in the treatment of circumferential mixed hemorrhoid with incarceration. Methods A total of 118 cases of circumferential mixed hemorrhoid with incarceration were divided into two groups., experimental group of 60 cases was treated by thrombus removal combined with PPH;control group of 58 cases was treated by Milligan-Morgan. We observed the differences of postoperative visual analogue scale （VAS） score, edema, bleeding, residual skin tag, wound healing time, anal stenosis, fecal incontinence,anorectal manometry and satisfaction in the two groups. Results There was significant difference between the experi- mental group and the control group in postoperative edema, bleeding and residual skin tag（x^2 = 6.63,4. 19,6.64, P〈0.05）, but postoperative anal stenosis and fecal incontinence weren＇t statistically significant different（x^2= 0.38,1.11, P〉0.05）. Postoperative VAS score, wound healing time, satisfaction, anal resting and anal maximal squeeze pressure between the two groups were all statistically different（P〈0.01）. Conclusion The operation of thrombus removal of external hemorrhoid combined with PPH can effectively reduce the postoperative complications and promote recovery.

关 键 词：肛门疾病 痔 手术后并发症 血栓 痔上黏膜环切钉合术 混合痔 嵌顿 外剥内扎术 

分 类 号：R657.18[医药卫生—外科学]