TST术与外切内扎术治疗重度混合痔的临床效果研究  

Clinical effect of TST and Milligan Morgan in the treatment of severe mixed hemorrhoids

作　　者：曹莹莹[1] Cao Yingying(Department of Anal ＆ Intestinal Surgery,Wanbei Coal-Electicity Group General Hospital,Suzhou,Anhui,234001,China)

机构地区：[1]皖北煤电集团总医院肛肠外科,安徽宿州234001

出　　处：《结直肠肛门外科》2018年第4期404-407,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨选择性痔上黏膜切除术(TST)和外切内扎术治疗重度混合痔的临床效果。方法纳入2015年3月至2017年3月在本院住院治疗的70例重度混合痔患者作为研究对象,随机分为两组,每组各35例。观察组行TST术,对照组行外切内扎术。比较两组手术基本情况、手术疗效、肛门功能及术后住院期间并发症发生情况。结果观察组术中出血量、住院时间和恢复工作时间及疼痛评分均优于对照组(均P<0.05),两组手术时间、总体疗效及住院期间并发症总发生率差异均无统计学意义(均P>0.05)。观察组手术前后肛管静息压(ARP)、直肠静息压(RRP)、肛管收缩压(SAP)差异均无统计学意义(均P>0.05),对照组术后ARP和SAP均低于术前(均P<0.05)。观察组术后创面渗血发生率低于对照组(P<0.05)。结论 TST和外切内扎术治疗重度混合痔总体疗效相近,前者有助于改善术后肛门功能及减少创面渗血的发生,有利于促进患者康复。Objective To study the clinical effect of Tissue-Selecting Therapy Stapler（TST） and Milligan-Morgan haemorrhoidectomy in the treatment of severe mixed hemorrhoids. Methods 70 patients with severe mixed hemorrhoids treated in our hospital from March 2015 to March 2017 were selected as the research subjects. They were randomly assigned into two groups, with 35 patients in each group. The treatment group received TST and the control group Milligan-Morgan haemorrhoidectomy. Indices related to the operation, clinical effect, anal function and postoperative complications during hospitalization were compared between the two groups. Results The amount of intraoperative blood loss, the duration of hospitalization and time to return to work and the score of pain were significantly lower or shorter in the treatment group than in the control group（P〈0.05）. There was no significant difference between the two groups in operation duration, total curative effect and the total incidence of postoperative complications during hospitalization（P〈0.05）. In the treatment group, there were no significant difference in anal rest pressure（ARP）, rectal resting pressure（RRP） and squeeze anal pressure（SAP） before and after the operation（P〈0.05）. In the control group, post-operative ARP and SAP were lower than pre-operative（P〈0.05）. The incidence of blood oozing was significantly lower in the treatment group than in the control group（P〈0.05）. Conclusion The overall curative effect of TST and Milligan-Morgan haemorrhoidectomy are comparable in the treatment of severe mixed hemorrhoids. However, TST is helpful in improving postoperative anal function and reducing blood oozing from the wound surface. It promotes recovery of the patients.

关 键 词：TST 外切内扎术 重度混合痔 

分 类 号：R657.1[医药卫生—外科学]