内套外剥保留齿线术治疗环状混合痔临床观察  

Clinical Observation on the Treatment of Annular Mixed Hemorrhoids with Inner Sleeve External Stripping Retained Tooth Line

作　　者：彭军良 陈丽芬 石冰 陆金根[2] 姚向阳 朱宝国 张华 张丹凤 杨君君 郭其乐 沈冬晓 

机构地区：[1]上海市金山区中西医结合医院,上海201501 [2]上海中医药大学附属龙华医院,上海200032

出　　处：《中国中医急症》2017年第12期2214-2217,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：上海市中医药(中医专科)专门人才计划(ZY3-RCPY-3-1014);上海市金山区科学技术创新资金项目(2014-3-11);上海市医学重点专科建设项目(ZK2015B11);国家中医药管理局全国名老中医药专家传承工作室建设项目-陆金根全国名老中医药专家传承工作室([2016]167);第三批上海市中医临床优势专科建设项目(ZYSNXD-YL-YSZK031);上海市优秀青年中医临床人才培养计划资助项目(ZYSNXD011-RC-XLXX-20110022);上海市金山区中西医结合医院院内课题(2016-8)

摘　　要：目的观察内套外剥保留齿线术治疗环状混合痔的疗效并探讨其机制。方法 60例患者按随机数字表法分为治疗组和对照组,各30例。治疗组采用内套外剥保留齿线术治疗,对照组采用分段外剥内扎术治疗,比较两组临床疗效、创面愈合时间、术后主要并发症(尿潴留、肛门疼痛、便血、肛缘水肿、肛门失禁)的差异;术后门诊随访6个月,观察两组远期疗效的差异。结果治疗组与对照组临床疗效差别不大(P>0.05)。治疗组创面平均愈合时间(20.67±1.95)d短于对照组(24.63±2.89)d(P<0.05)。治疗组术后肛门疼痛、肛缘水肿、便血、尿潴留、肛门失禁发生率均低于对照组(均P<0.05)。术后6个月门诊随访,两组均无肛门失禁发生;治疗组皮赘残留、肛门狭窄发生率均低于对照组(均P<0.05);治疗组复发率与对照组差别不大(P>0.05)。结论内套外剥保留齿线术治疗环状混合痔,可促进创面愈合,降低术后并发症,远期疗效满意。Objective： To observe the curative effect of internal sleeve external stripping retaining teeth line in the treatment of annular mixed hemorrhoid. Methods： 60 cases of annular mixed hemorrhoid patients were ran- domly divided into the treatment group and the control group, 30 cases in each group. The treatment group used internal sleeve external stripping retaining teeth line treatment, while the control group adopted subsection external dissection and internal ligation. The differences in clinical efficacy,wound healing time and postoperative compli- cations were compared between groups （urinary retention,anal pain,hematochezia,anal edema and anal inconti, neuce）. The follow-up period was 6 months. The long-term effects of the two groups were observed. Results： There was no significant difference in the clinical efficacy between the treatment group and the control group （P〉 0.05）. The wound healing time of the treatment group was （20.67±1.95） d,and that of the control group was （24,63±2.89） d. There was significant difference between the two groups （P〈 0.05）. The postoperative anal pain, anal edema, bleeding,urinary retention, anal incontinence＇rate of the treatment group was lower than those of the control group, and the difference was statistically significant（P〈 0.05）. After 6 months＇ follow-up, the incidence of residual skin lesions and anal stenosis in the treatment group was better than that in the control group, and the difference was statistically significant （P〈 0.05）. There was no obvious difference in recurrent rate between the treatment group and the control group （P〈 0.05）~ Conclusion： Inner sleeve external stripping retained tooth line treatment on annular mixed hemorrhoid can promote wound healing, reduce postoperative complications, and long- term curative effect is satisfactory.

关 键 词：环状混合痔 内套外剥保留齿线术 分段外剥内扎术 

分 类 号：R266[医药卫生—中医外科学]