自动弹力线痔套扎术治疗重度混合痔并直肠黏膜脱垂的临床效果分析  

Clinical effect of Ruiyun Procedure for Hemorrhoid for the treatment of severe mixed hemorrhoids with rectal mucosal prolapse

作　　者：孙旭[1] 徐孟[1] 郭旭[1] Sun Xu;Xu Meng;Guo Xu(Department of Anorectal Diseases,Central Hospital of Dalian,Dalian,Liaoning,116000,China)

机构地区：[1]大连市中心医院肛肠科,辽宁大连116000

出　　处：《结直肠肛门外科》2018年第4期407-411,共5页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨自动弹力线痔套扎术(RPH)治疗重度混合痔并直肠黏膜脱垂的临床效果。方法纳入本院2016年1月至12月收治的重度混合痔并直肠黏膜脱垂患者132例,按照随机数字表法分为观察组和对照组,每组各66例。对照组行传统外剥内扎术,观察组行RPH术。比较两组手术疗效以及围术期指标,利用肛门失禁评分量表(Wexner)评估两组术前、术后的肛门功能,术后随访6个月,观察并记录并发症发生率及复发率。结果观察组治疗总有效率为96.97%,对照组为95.45%,差异无统计学意义(P>0.05)。观察组术中出血量、创面愈合时间、住院时间分别为(2.64±0.29)m L、(8.75±1.29)d、(2.82±0.24)d,均优于对照组,差异均有统计学意义(均P<0.05)。观察组术后气体、生活方式改变、需衬垫评分及总分均低于对照组,差异均有统计学意义(均P<0.05)。观察组并发症总发生率为3.03%,低于对照组的13.64%,差异有统计学意义(P<0.05)。观察组6个月内的复发率为6.06%,对照组为9.09%,差异无统计学意义(P>0.05)。结论 RPH术在重度混合痔并直肠黏膜脱垂治疗中不仅能取得良好疗效,而且可减少术中出血量、促进创面愈合及肛门功能恢复,术后并发症较少,值得临床推广应用。Objective To investigate the effect of Ruiyun Procedure for Hemorrhoid（RPH） in treating severe mixed hemorrhoids with rectal mucosal prolapse. Methods 132 patients with severe mixed hemorrhoids and rectal mucosa prolapse treated in our hospital from January to December 2016 were recruited. They were randomly assigned to treatment group and control group, with 66 patients in each group, using random number table. The control group received the Milligan-Morgan haemorrhoidectomy and the treatment group received RPH. The curative effect and perioperative indicators were compared between the two groups. Pre-and postoperative anal function was evaluated using the Anus Incontinence Rating Scale（Wexner） and was compared between the two groups. Patients were followed-up for 6 months and we recorded incidence of complications and recurrence rate. Results The total effective rate was 96.97% in the treatment group, which was 95.45% in the control group, and the difference was not statistically significant（P〈0.05）. The amount of blood loss, time to wound healing and hospitalization duration in the treatment group were（2.64±0.29） m L,（8.75±1.29） d and（2.82±0.24） drespectively, they were less or shorter than in the control group and these differences were statistically significant（P〈0.05）. The scores of postoperatively gas, lifestyle changes, needs of padding score and total score in the treatment group were all lower than in the control group, and the differences were statistically significant（P〈0.05）. The incidence of complication was 3.03% in the treatment group, which was lower than in the control group（13.64%）, and the difference was statistically significant（P〈0.05）. The recurrence rate in 6 months was 6.06% in the treatment group, which was 9.09% in the control group, and the difference was not statistically significant（P〈0.05）. Conclusion RPH surgery in the treatment of severe mixed hemorrhoids and rectal mucosa prolapse can not only achieve good curative effect,

关 键 词：重度混合痔 直肠黏膜脱垂 RPH 并发症 

分 类 号：R657.1[医药卫生—外科学]