外剥内扎术中应用低温等离子刀治疗Ⅲ～Ⅳ°混合痔的临床研究  

Effect of low-temperature plasma knife in dissection and ligation for the treatment of stage Ⅲ~Ⅳ mixed hemorrhoids

作　　者：姜鹏君[1] 刘恒良 龚颖生[1] 邵明[1] 霍超[1] 丘秀娟 马国珍[2] 彭文[1] Jiang Pengjun;Liu Hengliang;Gong Yingsheng;Shao Ming;Huo Chao;Qiu Xiujuan;Ma Guozhen;Peng Wen(Department of Anus ＆ Intestine Surgery;Department of General Medicine, Nanshan People＇s Hospital, Shenzhen Sixth People＇s Hospital, Shen- zhen, Guangdong, 518052, China)

机构地区：[1]深圳市南山区人民医院.深圳市第六人民医院肛肠外科,广东深圳518052 [2]深圳市南山区人民医院.深圳市第六人民医院全科医学科,广东深圳518052

出　　处：《结直肠肛门外科》2018年第3期285-288,共4页Journal of Colorectal & Anal Surgery

基　　金：深圳市南山区科技计划项目(编号:南科研卫2017031号)

摘　　要：目的观察外剥内扎术中应用低温等离子刀治疗Ⅲ~Ⅳ°混合痔的临床效果及对患者炎性因子水平的影响。方法纳入100例Ⅲ~Ⅳ°混合痔患者作为研究对象,随机分为两组,每组各50例。观察组行低温等离子刀外剥内扎术,对照组行传统外剥内扎术。比较两组治疗效果、手术相关指标、术后并发症发生率及手术前后炎性因子水平。结果两组患者治愈率均超过90%,两组手术总体疗效差异无统计学意义(P>0.05);观察组术中出血量、术后恢复工作时间、住院时间及创面愈合时间均少于对照组,差异均有统计学意义(均P<0.05);观察组并发症发总生率低于对照组(P<0.05),两组并发症严重程度差异无统计学意义(P>0.05)。观察组术后1 w时血清IL-6、IL-17及IFN-γ低于对照组和术前,差异均有统计学意义(均P<0.05)。结论低温等离子刀联合外剥内扎术治疗Ⅲ~Ⅳ°混合痔可获得与传统外剥内扎术一致的临床疗效,且术后并发症更少,炎性反应轻,患者术后恢复更快。Objective To study the effect of low-temperature plasma knife in dissection and ligation for the treatment of stage Ⅲ~Ⅳmixed hemorrhoids and its effect on the levels of inflammatory factors. Methods 100 patients with stage Ⅲ ~ Ⅳ mixed hemorrhoids were included in the study. They were assigned into two groups, with 50 cases in each group. The treatment group received low temperature plasma knife in dissection and ligation and the control group received traditional dissection and ligation. The effectiveness, perioperative indices, postoperative complications and the levels of inflammatory factors before and after surgery were compared between the two groups. Results The cure rate of the two groups were more than 90%. There was no statistical significance difference in overall effectiveness between the two group（P〈0.05）. Amount of intraoperative bleeding, time to postoperative work, the hospitalization time and time to wound healing in the treatment group were significantly lower than in the control group（P〈0.05）. The total incidence of complications in the treatment group was lower than that in the control group（P〈0.05）. There was no significant difference in the severity of complications between the two groups（P〉0.05）. In the treatment group, the levels of IL-6, IL-17 and IFN-γ at 1 week after operation were significantly lower than before the operation and lower than in the control group, with statistically significant differences（P〈0.05）. Conclusion The use of low-temperature plasma knife combined with dissection and ligation can have comparable clinical effect as traditional dissection and ligation. It is associated with fewer postoperative complications, less inflammatory response,and faster recovery.

关 键 词：低温等离子刀 外剥内扎术 混合痔 临床疗效 

分 类 号：R657.1[医药卫生—外科学]