自动痔疮套扎术治疗Ⅲ～Ⅳ度混合痔患者的有效性分析  

Analysis of Effectiveness of Automatic Hemorrhoids Ligation in Treatment of Patients with Ⅲ-Ⅳ Mixed Hemorrhoids

作　　者：殷毅 吴桂喜 王伟杰 张双民[2] YIN Yi;WU Guixi;WANG Weijie;ZAHGN Shuangmin(Department of Colorectal Surgery,Beijing Longfu Hospital,Beijing 100010,China;Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京市隆福医院肛肠外科,北京100010 [2]中国医学科学院北京协和医院基本外科,北京100730

出　　处：《医学综述》2019年第18期3724-3727,共4页Medical Recapitulate

基　　金：北京市东城区优秀人才培养资助项目(2015QWWJGW-2)

摘　　要：目的 分析自动痔疮套扎术治疗Ⅲ~Ⅳ度混合痔患者的有效性。方法 选择2015年6月至2016年12月北京市隆福医院肛肠外科收治的74例Ⅲ~Ⅳ度混合痔患者为研究对象,依据治疗方法不同分为观察组和对照组,各37例。观察组接受自动痔疮套扎术治疗,对照组接受外剥内扎术治疗。比较两组患者治疗后的临床疗效,手术、术后指标及术后并发症情况,术后随访1年,统计两组患者术后复发情况。结果 观察组总有效率为97.30%(36/37),对照组为83.78%(31/37),观察组临床疗效优于对照组(P<0.05)。观察组手术时间、术后首次排便时间、住院时间及创面愈合时间均短于对照组[(25.1±3.2)min比(33.7±3.7)min,(51.4±2.4)h比(63.3±2.5)h,(6.8±1.2)d比(10.0±1.3)d,(8.7±2.1)d比(12.9±2.4)d](P<0.01)。观察组术后总并发症发生率低于对照组[2.70%(1/37)比18.92%(7/37)](P<0.05)。随访期间,观察组患者疾病复发率为2.70%,对照组为5.41%,两组比较差异无统计学意义(P>0.05)。结论 自动痔疮套扎术治疗Ⅲ~Ⅳ度混合痔患者的临床疗效显著,手术安全性高,患者术后恢复快,且不易复发。Objective To analyze the effectiveness of automatic hemorrhoids ligation in the treatment of patients withⅢ-Ⅳ mixed hemorrhoids. Methods A total of 74 patients with grade Ⅲ-Ⅳ mixed hemorrhoids admitted to Beijing Longfu Hospital from Jun. 2015 to Dec. 2016 were included in the study,and divided into an observation group( n = 37) and a control group( n = 37) according to different treatment methods. The observation group was treated with automatic hemorrhoids entrapment,while the control group was treated with external stripping and internal ligation. The clinical efficacy,operation,postoperative indexes and postoperative complications were compared between the two groups. The patients in the two groups were followed up for 1 year,and the recurrence of the two groups was recorded. Results The total effective rate was 97. 30%( 36/37) in the observation group and 83. 78%( 31/37) in the control group,the observation group better than the control group( P < 0. 05). The operation time,first postoperative defecation time,hospital time and wound healing time of the observation group were shorter[( 25. 1 ± 3. 2) min vs( 33. 7 ± 3. 7) min,( 51. 4 ± 2. 4) h vs( 63. 3 ± 2. 5) h,( 6. 8 ± 1. 2) d vs( 10. 0 ± 1. 3) d,( 8. 7 ± 2. 1) d vs( 12. 9 ± 2. 4) d]( P < 0. 01). The incidence of postoperative complications in the observation group was lower[2. 70%( 1/37) vs 18. 92%( 7/37)]( P < 0. 05). During the follow-up period,the recurrence rate was 2. 70% in the observation group and 5. 41% in the control group,no significant difference between the two groups( P > 0. 05). Conclusion Clinical effect of automatic hemorrhoids ligation in the treatment of patients withⅢ-Ⅳ mixed hemorrhoids is significant,which is characterized by high operation safety,fast postoperative recovery and less recurrence.

关 键 词：混合痔 自动痔疮套扎术 并发症 复发 

分 类 号：R657.18[医药卫生—外科学]