串联式套扎法结合外痔切除术治疗老年混合痔患者的临床观察  

Effect of tandem ligation combined with external hemorrhoidectomy in older patients with mixed hemorrhoids

作　　者：胡立强 席志强 

机构地区：[1]北京市通州区老年病医院普外科,北京101100 [2]北京市通州区老年病医院外科,北京101100

出　　处：《结直肠肛门外科》2018年第1期42-45,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的观察串联式套扎法结合外痔切除术治疗老年混合痔的临床疗效。方法选取本院2013年2月至2015年10月收治的96例老年混合痔患者为研究对象,随机分为观察组与对照组,每组各48例。观察组采取串联式套扎法结合外痔切除术治疗,对照组采取外剥内扎术。比较两组治愈率、手术时间、术中出血量、术后便血、疼痛、肛门水肿等并发症严重程度及随访半年的复发率与后遗症发生率。结果两组治愈率分别为93.75%、87.50%,差异无统计学意义(P>0.05)。观察组手术时间、术中出血量、便血评分、疼痛评分、肛门水肿评分分别为(21.35±4.38)min、(9.85±1.87)m L、(1.52±0.69)分、(2.11±0.68)分、(0.94±0.35)分,均显著优于对照组(均P<0.05)。两组随访期间复发率分别为0、4.17%,后遗症总发生率为2.08%、10.42%,差异均无统计学意义(均P>0.05)。结论与外剥内扎术相比,串联式套扎法联合外痔切除术治疗老年混合痔手术耗时更短、术中出血量更少,且术后便血、疼痛及肛门水肿程度更轻。Objective To investigate the effect of tandem ligation combined with external hemorrhoids in treatment of older patients with mixed hemorrhoids. Methods 96 older patients with mixed hemorrhoids admitted to our hospital from February 2013 to October2015 were selected and randomly assigned to the treatment group and the control group, with 48 cases in each group. The treatment group received tandem ligation combined with external hemorrhoids resection, and the control group received Milligan-Morgan. Curative rate, operation duration, intraoperative bleeding amount, postoperative bleeding, pain, anal edema, other severe complications, and recurrence rate and incidence of sequelae half a year after treatment were compared between the two groups. Results The curative rates in the two groups were 93.75% and 87.50%, respectively, and the difference was not statistically significant（P〈0.05）. The operative time, blood loss, bleeding score, pain score, anal edema scores in the treatment group were（21.35 ＋ 4.38） min,（9.85 ＋ 1.87）m L,（1.52 ＋ 0.69） scores,（2.11 ＋ 0.68） scores,（0.94 ＋ 0.35） scores, respectively, and they were significantly better than those in the control group（all P〈0.05）. The recurrence rates during the follow-up period in the two groups were 0 and 4.17%, respectively. The total incidence of sequelae was 2.08% and 10.42%, respectively, and the difference was not statistically significant（P〉0.05）. Conclusion Compared with Milligan-Morgan, tandem ligation combined with external hemorrhoids resection is less time-consuming and has less intraoperative bleeding, postoperative pain, hematochezia, and anal edema in the treatment of older patients with mixed hemorrhoid surgery.

关 键 词：老年患者 混合痔 串联式套扎法联合外痔切除术 外剥内扎术 

分 类 号：R657.1[医药卫生—外科学]