Ligasure痔切除术治疗Ⅲ、Ⅳ度混合痔患者临床疗效观察  

Effect of Ligasure hemorrhoidectomy for grade Ⅲ and Ⅳ hemorrhoids

作　　者：陈艳妮[1] 侯孝涛 陈浩[1] 任碧云 邵万金[2] 张波[3] Chen Yanni;Hou Xiaotao;Chen Hao;Ren Biyun;Shao Wanjin;Zhang Bo(Department of Anorectal Diseases, Zhongda Hospital Southeast University(JiangBei), Nanjing 210043, Jiangsu, China;Department of Anorectal Diseases, Jiangsu Province Hospital of Chinese Medicine, Nanjing 210000, Jiangsu, China;Department of Anorectal Diseases, Zhongda Hospital Southeast University, Nanjing 210000, Jiangsu, China)

机构地区：[1]东南大学附属中大医院江北院区肛肠科,江苏南京210043 [2]江苏省中医院肛肠科,江苏南京210000 [3]东南大学附属中大医院肛肠科,江苏南京210000

出　　处：《结直肠肛门外科》2019年第5期537-541,共5页Journal of Colorectal & Anal Surgery

基　　金：江苏省自然科学基金项目（BK20171078）

摘　　要：目的探讨Ligasure痔切除术治疗Ⅲ、Ⅳ度混合痔患者临床疗效。方法选取2017年7月至2018年12月在东南大学附属中大医院江北院区住院的60例Ⅲ、Ⅳ度混合痔患者为研究对象,按照随机数字表法将其分为对照组(n=30)和Ligasure组(n=30)。对照组行传统痔切除术,Ligasure组行Ligasure痔切除术。观察记录临床疗效,并比较两组手术时间、术中出血量、住院时间、术后不同时点视觉模拟评分法(VAS)评分、创面愈合时间及术后并发症发生情况。结果Ligasure组患者治疗总有效率高于对照组(P<0.05)。Ligasure组术中出血量少于对照组,住院时间短于对照组,差异均有统计学意义(均P<0.05)。两组术后6hVAS评分最高,随着术后时间延长,两组VAS评分均渐渐降低;且Ligasure组术后6h、24h、48h、14d及28dVAS评分均低于对照组(均P<0.05)。Ligasure组术后创面愈合时间短于对照组(P<0.05)。两组尿潴留、创面感染、术后出血、肛门坠胀、肛门狭窄及肛缘水肿发生率相比,差异均无统计学意义(均P>0.05)。结论Ⅲ、Ⅳ度混合痔患者行Ligasure痔切除术可提高疗效,不仅能减少术中出血量、缩短住院时间、减轻患者术后痛苦,更利于患者术后恢复,同时又不增加术后并发症的发生率。Objectives To investigate the effect of Ligasure hemorrhoidectomy for grade Ⅲ and Ⅳ hemorrhoids. Methods Sixty patients with grade Ⅲ and Ⅳ mixed hemorrhoids were recruited in Zhongda Hospital Southeast University(JiangBei) between July 2017 and December 2018. They were randomly assigned to the control group and Ligasure group with 30 patients in each group. Patients in the control group received traditional hemorrhoidectomy, and those in the Ligasure group received Ligasure hemorrhoidectomy. The followings were recorded: effectiveness, duration of surgery, intraoperative blood loss, length of hospitalization, postoperative visual analog scale(VAS), time to wound healing, and postoperative complications. Results Overall effectiveness rate was significantly higher, intraoperative blood loss was significantly less, length of hospitalization was significantly shorter in the Ligasure group than in the control group(P < 0.05). Postoperative VAS score was the highest at 6 hours after surgery,but gradually decreased afterward. Patients in the Ligasure group had significantly lower VAS scores at 6, 24, and 48 hours, 14 and 28 days after surgery compared with those in the control group(P < 0.05). There was no significant difference between the two groups in the incidence of urinary retention, wound infection, postoperative bleeding, anal straining, anal stenosis and edema of anal edge(P > 0.05). Conclusion Ligasure hemorrhoidectomy is effective for grade Ⅲ and Ⅳ hemorrhoids. It can reduce intraoperative blood loss andlength of hospitalization, lower postoperative pain, and promote recovery. while at the same time, it does not increase the incidence of postoperative complications.

关 键 词：混合痔 LIGASURE血管闭合系统 传统痔切除术 

分 类 号：R657.1[医药卫生—外科学]