倒“T”口外剥内注悬吊法用于老年非环状混合痔手术的价值研究  

Effect of reverse T incision with external stripping and internal injection and suspension in non-circumferential mixed hemorrhoids in old patients

作　　者：刘彦合 李慧[2] 叶晓谊 曾祥勇 Liu Yanhe;Li Hui;Ye Xiaoyi;Zeng Xiangyong(Department of General Surgery,The Second Affiliated Hospital of Hainan Medical School,Haikou 570311,Hainan,China;Department of Geriatrics,The Second Affiliated Hospital of Hainan Medical School,Haikou 570311,Hainan,China)

机构地区：[1]海南医学院第二附属医院普外科,海南海口570311 [2]海南医学院第二附属医院老年病科,海南海口570311

出　　处：《结直肠肛门外科》2019年第3期307-310,共4页Journal of Colorectal & Anal Surgery

基　　金：海南省自然科学基金(310159)

摘　　要：目的探讨倒“T”口外剥内注悬吊法用于老年非环状混合痔手术的价值。方法选择2016年1月至2018年6月收治的108例老年非环状混合痔手术患者,按随机信封法划分为观察组和对照组,每组各54例。观察组接受倒“T”口外剥内注悬吊法治疗,对照组接受常规外剥内扎术治疗。对比两组手术效果、临床疗效、术后24h及首次排便疼痛积分、术后近期并发症情况、术后6个月肛门功能。结果两组临床疗效对比,差异无统计学意义(P>0.05)。术后24h及首次排便时观察组疼痛程度均轻于对照组(均P<0.05)。观察组术中出血量少于对照组,术后住院时间短于对照组(P<0.05)。观察组水肿、尿潴留、皮赘残留、肛门狭窄发生率均低于对照组(均P<0.05)。术后6个月时观察组肛门功能优于对照组,差异有统计学意义(P<0.05)。结论倒“T”口外剥内注悬吊法治疗老年非环状混合痔疗效确切,有助于减少术后近期并发症,并保护患者肛门功能。Objectives To investigate the effect of reverse T incision with external stripping and internal injection and suspen. sion in non-circumferential mixed hemorrhoids in old patients. Methods A total of 108 old patients with non-circumferential mixed hemorrhoids treated between January 2016 and June 2018 were recruited and randomly assigned to treatment group and control group, with 54 patients in each groupby using sealed envelopes. Patients in the treatment group received reverse T inci. sion with external stripping and internal injection and suspension and those in the control group received regular seton. The fol. lowing were compared between the two groups: clinical effectiveness, pain in the first 24 hours after surgery and during first defe. cation, short-term complications, and anal function at 6 months after surgery. Results Clinical effectiveness was similar between the groups (P > 0.05). Pain in the first 24 hours after surgery and during first defecation was significantly lower in the treat. ment group than in the control group (P < 0.05). Blood loss during surgery was significantly less in the treatment group, dura. tion of hospitalization was significantly shorter in the treatment group(P < 0.05). Incidence of edema, urinary retention, residual dermatophytes and anal stricture were significantly less in the treatment group (P < 0.05). Anal function at 6 months after sur. gery was significantly better in the treatment group (P < 0.05). Conclusion Reverse T incision with external stripping and inter. nal injection and suspension is effective in treating non-circumferential mixed hemorrhoids in old patients. It could both reduce postoperative short-term complications and preservet anal function.

关 键 词：混合痔 倒“T”口外剥内注悬吊法 临床疗效 

分 类 号：R657.1[医药卫生—外科学]