切闭术与PPH治疗Ⅱ~Ⅳ度内痔的效果比较  

Comparison of clinical efficacy between excision-closed hemorrhoidectomy and procedure for prolapse and hemorrhoids for II-IV degree internal hemorrhoids

作　　者：莫辉 范显文 梁君林[2] 叶大才 Mo Hui;Fan Xianwen;Liang Junlin;Ye Dacai(Wuzhou Worker＇s Hospital, Wuzhou, Guangxi, 543000, China;The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China)

机构地区：[1]梧州市工人医院,广西梧州543000 [2]广西医科大学第一附属医院,广西南宁530021

出　　处：《结直肠肛门外科》2018年第2期160-163,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的比较切闭术与吻合器痔上黏膜环切术(PPH)治疗Ⅱ~Ⅳ度内痔的临床效果。方法回顾性分析2016年10月1日至2017年4月1日于梧州市工人医院接受切闭术或PPH治疗的86例Ⅱ~Ⅳ度内痔患者临床资料,按照手术方式的不同分为切闭术组与PPH组,每组各43例。比较两组总体疗效、手术时间、住院时间,术后并发症(肛门疼痛、尿潴留、肛缘水肿、肛门坠胀、术后1个月肛门坠胀感以及吻合口狭窄)发生情况。结果切闭术组的总体疗效与PPH组相当,差异无统计学意义(P>0.05)。切闭术组手术时间短于PPH组(P<0.05),两组住院时间差异无统计学意义(P>0.05)。切闭术组术后肛缘水肿、肛门疼痛及肛门坠胀发生率高于PPH组(均P<0.05),两组尿潴留及手术后1个月坠胀感发生率差异无统计学意义(均P>0.05),两组均无吻合口狭窄病例。结论在Ⅱ~Ⅳ度内痔治疗方面,切闭术与PPH近期总体疗效相近,切闭术操作更简单快捷,但术后肛门疼痛、肛门坠胀及肛缘水肿发生率较高。Objective To compare clinical efficacy between excision-closed hemorrhoidectomy and procedure for prolapse and hemorrhoids（PPH） for II-IV degree internal hemorrhoids. Methods A retrospective analysis of 86 patients with II-IV degree internal hemorrhoids treated in Wuzhou Worker＇s Hospital from October 1, 2016 to April 1, 2017 were selected. Patients were divided into two groups according to treatment received, either excision-closed hemorrhoidectomy or PPH. The overall efficacy, operation duration,hospitalization duration, and postoperative anal pain, urinary retention, perianal edema, anal bulge, anal bulge occurring one month after surgery and anastomotic stenosis were recorded. Results There was no siginficant difference between the two groups in overall efficacy（P 〈0.05）. The operation time shorter in excision-closed hemorrhoidectomy group than in PPH group（P 〈0.05）. There was no significant difference in hospitalization duration between two groups（P 〉0.05）. The rate of the postoperative perianal edema, anal pain and anal bulge was higher in excision-closed hemorrhoidectomy group than in PPH group（all P 〈0.05）. There was no difference in anal bulge, anal bulge one month after surgery between two groups（P 〉0.05）. No anastomotic stenosis was observed. Conclusion The overall efficacy of recent excision-closed hemorrhoidectomy and PPH groups was similar for the treatment for II ~IV degree hemorrhoids. The former was simple and quick, but had higher rate of postoperative anal pain, anal bulge and perianal edema.

关 键 词：内痔 痔切闭术 PPH 

分 类 号：R657.1[医药卫生—外科学]