痔上黏膜套叠缝合在痔吻合器上黏膜环切术中的应用  

Application of overlying superior hemorrhoidal mucosa intussusception suture in procedure for prolapse and hemorrhoids for the severe hemorrhiods

作　　者：齐保聚 杨进山 梁艳 QI Bao-ju;YANG Jin-shan;LIANG Yan(Department of Analrectal Surgery,Daxing Teaching Hospital,Capital Medical University,Beijing 102600,China)

机构地区：[1]首都医科大学大兴教学医院肛肠科,北京102600

出　　处：《局解手术学杂志》2018年第8期565-568,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨痔上黏膜套叠缝合在痔吻合器痔上黏膜环切术(PPH)中的应用效果。方法前瞻性研究分析2016年7月至2017年10月在首都医科大学大兴教学医院96例重度痔患者,其中47例患者选用痔上黏膜套叠缝合法(黏膜套叠缝合组),49例患者选用单荷包缝合线法(单荷包缝合组)。比较2组病例的手术时间、切除直肠黏膜宽度、黏膜环完整性及均匀度、痔核回缩率、术中出血、术后肛门疼痛及住院时间。结果黏膜套叠缝合组术后切除直肠黏膜宽度、痔核回缩率均优于单荷包缝合组,差异有统计学意义(P<0.05);2组患者术中出血、术后肛门疼痛、住院时间比较差异无统计学意义(P>0.05)。黏膜套叠缝合组的手术时间要大于单荷包缝合组,差异有统计学意义(P<0.05)。结论 PPH治疗重度痔结合痔上黏膜套叠缝合法在不增加住院时间及术后并发症的情况下,能够增加切除直肠黏膜的宽度及痔核回缩率。Objective To study the effect of prolapse and hemorrhoids on the treatment of severe hemorrhoids by procedure for prolapse and pemorrhoids（PPH）. Methods A total of 96 patients with severe hemorrhiods in Daxing teaching hospital of capital medical university from July 2016 to October 2017 were randomly assigned.Both groups were treated by PPH.Group A received overlying superior hemorrhoidal mucosa intussusception suture,group B received single purse string suture.The operation time,width and equitability of specimen,retraction of hemorrhoids,intraoperative bleeding,pain and hospital stay between two groups were compared.Results The width of rectal mucosa and the rate of retraction of hemorrhoids in the suture group were better than those in the single pocket suture group（P〈0.05）.There was no significant difference between the two groups in intraoperative bleeding,postoperative anal pain and hospital stay（P〉0.05）.The operative time of suture group was longer than that of single bag suture group （P〈0.05）.Conclusion Overlying superior hemorrhoidal mucosa intussusception suture can increase the width of rectal mucosa and the retraction of hemorrhoids without increasing the hospitalization time and postoperative complications.It has certain clinical popularization value in severe hemorrhoids patients.

关 键 词：吻合器痔上黏膜环切术 重度痔 套叠缝合 痔回缩率 手术时间 术中出血 

分 类 号：R657.18[医药卫生—外科学]