PPH联合超声刀治疗Ⅲ、Ⅳ度混合痔的临床效果研究  

Effect of PPH combined with harmonic scalpel in treating grade Ⅲ～Ⅳ mixed hemorrhoids

作　　者：高同刚 周爱岩[2] 路永超[2] Gao Tonggang;Zhou Aiyan;Lu Yongchao(Shandong University of Traditional Chinese Medicine,Ji’nan 250014,Shandong,China;Department of Anorectal Diseases,Shandong Provincial Hospital,Ji’nan 250021,Shandong,China)

机构地区：[1]山东中医药大学,山东济南250014 [2]山东省立医院肛肠科,山东济南250021

出　　处：《结直肠肛门外科》2019年第2期195-198,202,共5页Journal of Colorectal & Anal Surgery

基　　金：山东省科技发展计划项目(2013GSF11871);山东省重点研发计划(2015GSF118157)

摘　　要：目的探讨吻合器痔上黏膜环切术(PPH)联合超声刀治疗Ⅲ、Ⅳ度混合痔的临床疗效。方法选择山东省立医院肛肠科2017年6月至2018年3月期间收治的102例混合痔患者为研究对象,随机分为观察组(n=45)和对照组(n=57),其中观察组行PPH联合超声刀治疗,对照组行Milligan-Morgan联合超声刀治疗。比较两组手术相关指标、术后第3 d疼痛程度、术后并发症发生情况及手术治疗效果。结果观察组术中出血量少于对照组,住院时间和创面愈合时间短于对照组,差异均有统计学意义(均P <0.05),两组手术时间比较,差异无统计学意义(P> 0.05);观察组术后第3 d疼痛评分低于对照组,差异有统计学意义(P <0.05);观察组肛缘水肿发生率低于对照组,差异有统计学意义(P <0.05),两组术后并发症总发生率比较差异无统计学意义(P> 0.05);观察组总体疗效优于对照组,差异有统计学意义(P <0.05)。结论 PPH联合超声刀治疗Ⅲ、Ⅳ度混合痔疗效确切,能减少患者术中出血、减轻术后疼痛、加快创面愈合、缩短住院时间,有利于患者术后的康复。Objectives To investigate the effect of combining procedure for prolapseand hemorrhoids(PPH)and harmonic scalpel in treating gradeⅢ~Ⅳmixed hemorrhoids.Methods A total of 102 patients with mixed hemorrhoids treating in Shandong Provincial Hospital between June 2017 and March 2018 were recruited as study subjects and were randomly assigned to treatment group(n=45)and control group(n=57).Patients in the treatment group received combination treatment of PPH and harmonic scalpel and those in the control group received Milligan-Morgan hemorrhoidectomy with harmonic scalpel.Indices related to surgery,pain at the 3rd day after surgery,incidence of postoperative complications,and effectiveness were compared between the two groups.Results Intraoperative blood loss was significantly less,and duration of hospitalization and time to wound healing significantly shorter in the treatment group than in the control group(P<0.05).Duration of surgery did not differ significantly between the two groups(P>0.05).Pain score at the 3rd day after surgery was significantly lower in the treatment group than in the control group(P<0.05).Total incidence of postoperative complications was similar between the two group(P>0.05),however,perianal edema occurred significantly less in the treatment group(P<0.05).Overall effectiveness was significantly better in the treatment group than in the control group(P<0.05).Conclusion Combining PPH and harmonic scalpel for gradeⅢ~Ⅳmixed hemorrhoids was effectiveness and could reduce intraoperative blood loss,reduce postoperative pain,promote wound healing,shorten hospitalization,and promote postoperative recovery.

关 键 词：混合痔 吻合器痔上黏膜环切术 MILLIGAN-MORGAN术 超声刀 

分 类 号：R657.1[医药卫生—外科学]