痔上黏膜缝扎结合内扎外剥术治疗环状重度脱垂性混合痔的临床观察  

Clinical observation on hemorrhoid mucosa ligation combined with Milligan-Morgan hemorrhoidectomy in the treatment of annular severe-prolapsed mixed hemorrhoids

作　　者：赵文俊 汪庆明 胡峻[2] 邹琪琦[2] 杨达成 何笠 徐进 朱静怡[2] ZHAO Wenjun;WANG Qingming;HU Jun;ZOU Qiqi;YANG Dacheng;HE Li;XU Jin;ZHU Jingyi(Anorectal Department,Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201999,China;Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海市宝山区中西医结合医院肛肠科,上海201999 [2]上海中医药大学附属曙光医院,上海201203

出　　处：《上海中医药大学学报》2020年第2期37-40,共4页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：上海市卫计委中医优势病种培育项目(zybz-2017018)。

摘　　要：目的:比较痔上黏膜缝扎结合内扎外剥术与传统内扎外剥术治疗环状重度脱垂性混合痔的临床疗效。方法:纳入240例环状重度脱垂性混合痔患者,随机分为治疗组和对照组,每组各120例。治疗组患者采用痔上黏膜缝扎结合外剥内扎术治疗,对照组患者采用传统外剥内扎术治疗。比较两组患者的手术时间、术中出血量及住院天数、住院费用,于术后1、3、7 d及1、3个月评价患者的术后出血及脱垂情况。结果:①与对照组比较,治疗组患者的术中出血量明显减少(P<0.01),手术时间明显缩短(P<0.01)。②术后第7天,治疗组患者的出血情况明显优于对照组(P<0.01);两组患者各观察时点的脱垂情况比较,差异均无统计学意义(P>0.05)。③与对照组比较,治疗组患者的住院费用明显减少(P<0.01),住院天数明显缩短(P<0.01)。结论:与传统内扎外剥术相比,痔上黏膜缝扎结合内扎外剥术治疗环状重度脱垂性混合痔具有手术操作简单、出血少、住院时间短、住院费用低等优点,值得临床推广。Objective: To compare the clinical efficacy of hemorrhoid mucosa ligation combined with Milligan-Morgan hemorrhoidectomy and traditional Milligan-Morgan hemorrhoidectomy in the treatment of annular severe-prolapsed mixed hemorrhoids. Methods: Two hundred and forty patients with annular severe-prolapsed mixed hemorrhoids were enrolled and randomly divided into the treatment group and control group, 120 cases in each group. The patients in the treatment group were treated with hemorrhoid mucosa ligation combined with Milligan-Morgan hemorrhoidectomy, and the patients in the control group were treated with traditional Milligan-Morgan hemorrhoidectomy. The operation time, the amount of intraoperative bleeding, the hospitalization days and the hospitalization costs were compared between the two groups, and one day, three days, seven days, one month and three months after operation, the bleeding and prolapse were evaluated. Results: ①Compared with the control group, the amount of intraoperative bleeding in the treatment group was significantly reduced(P<0.01), and the operation time was significantly shortened(P<0.01). ②On the 7 th day after operation, the bleeding of the treatment group was significantly superior to the control group(P<0.01), and there was no statistically significant difference on prolapse between the two groups at all observation points(P>0.05). ③Compared with the control group, the hospitalization costs of the treatment group were significantly reduced(P<0.01), and the hospitalization days were significantly shortened(P<0.01).Conclusion: Compared with traditional Milligan-Morgan hemorrhoidectomy,hemorrhoid mucosa ligation combined with Milligan-Morgan hemorrhoidectomy shows the advantages of simple operation,less bleeding,shorter hospitalization days and lower hospitalization costs,which is worthy of clinical application and popularization.

关 键 词：痔上黏膜缝扎 内扎外剥术 环状重度脱垂性混合痔 

分 类 号：R657.18[医药卫生—外科学]