低温等离子刀联合外剥内扎术治疗混合痔的临床效果  

Clinical effects of cryogenic plasma knife combined with milligan-morgan hemorrhoidectomy in the treatment of mixed hemorrhoids

作　　者：刘恒良 姜鹏君[1] 彭文[1] 龚颖生[1] 邵明[1] LIU Heng-liang;JIANG Peng-jun;PENG Wen;GONG Ying-sheng;SHAO Ming(Deparment of Anorectal Surgery,People′s Hosptial of Nanshan District of Shenzhen City in Guangdong Province,Shenzhen 518052,China)

机构地区：[1]深圳市南山区人民医院肛肠外科

出　　处：《中国当代医药》2019年第22期69-72,76,共5页China Modern Medicine

基　　金：广东省深圳市南山区科技计划项目(南科研卫2017031号)

摘　　要：目的探讨低温等离子刀联合外剥内扎术治疗混合痔的临床效果。方法选择2016年2月~2018年5月我院收治的225例混合痔患者作为研究对象,依据电脑随机分为等离子组、高频电刀组和外剥内扎组,各75例。等离子刀组采用传统外剥内扎联合低温等离子刀术,高频电刀组采用传统外剥内扎联合高频电刀术,外剥内扎组采用传统的外剥内扎术。观察比较三组患者的总体疗效、术中出血量、手术时间、术后伤口疼痛、肛缘水肿、平均愈合时间。结果三组患者的治疗总有效率比较,差异无统计学意义(P>0.05);高频电刀组的手术时间明显短于等离子组和外剥内扎组,等离子组的手术时间短于外剥内扎组,差异均有统计学意义(P<0.05);外剥内扎组的术中出血量多于等离子组和高频电刀组,差异有统计学意义(P<0.05);等离子组和高频电刀组的术中出血量比较,差异无统计学意义(P>0.05);等离子组术后第1、2、3天的伤口疼痛评分均显著低于高频电刀组和外剥内扎组,差异均有统计学意义(P<0.05);三组术后的肛缘水肿评分分别为(0.75±0.81)、(1.31±0.89)、(0.87±0.76)分,高频电刀组的肛缘水肿评分高于等离子组和外剥内扎组,差异均有统计学意义(P<0.05);等离子组和外剥内扎组的肛缘水肿评分比较,差异无统计学意义(P>0.05)。三组患者的切口愈合时间比较,差异无统计学意义(P>0.05)。结论低温等离子刀配合外剥内扎术治疗混合痔的效果确切,在手术时间、术中出血量、术后肛缘水肿及伤口疼痛等方面均明显减少,减轻了患者的痛苦,具体疗效有待大样本多中心随机对照研究。Objective To investgate the clinical effects of cryogenic plasma knife combined with milligan-morgan hemorrhoidectomy in the treatment of mixed hemorrhoids.Methods A total of 225 patients with mixed hemorrhoids admitted to our hospital from February 2016 to May 2018 were selected as the research objects.The patients were divided into the plasma group,the high frequency electrotome group and the milligan-morgan hemorrhoidectomy group according to computer random method.The plasma knife group was treated with traditional milligan-morgan hemorrhoidectomy combined with cryogenic plasma knife knife.The high frequency electrotome group was treated with traditional milligan-morgan hemorrhoidectomy combined with high frequency electrotome.The milligan-morgan hemorrhoidectomy group was treated with traditional milligan-morgan hemorrhoidectomy.The overall curative effect,intraoperative bleeding volume,operation time,postoperative wound pain,anal edema and average healing time of the three groups were observed and compared.Results There was no significant difference in the total effective rate among the three groups (P>0.05).The operation time of the high frequency electrotome group was significantly shorter than that of the plasma group and the milligan-morgan hemorrhoidectomy group,the operation time of the plasma group was shorter than that of the milligan-morgan hemorrhoidectomy group,the difference was statistically significant (P<0.05).The amount of intraoperative bleeding in the milligan-morgan hemorrhoidectomy group was more than that in the plasma group and the high frequency electrotome group,the difference was significant (P<0.05).There was no significant difference in intraoperative bleeding between the plasma group and the high frequency electrotome group (P>0.05).The wound pain scores of the plasma group on the 1st,2nd and 3rd day after operation were significantly lower than those of the high frequency electrotome group and the milligan-morgan hemorrhoidectomy group,the difference was significant (P<0.05).The

关 键 词：低温等离子刀 外剥内扎术 混合痔 临床效果 

分 类 号：R657.18[医药卫生—外科学]