吻合器痔上黏膜环切术联合超声刀治疗重度混合痔的临床效果  

Clinical effect of anastomotic sacral circumcision combined with ultrasonic scalpel in the treatment of severe mixed hemorrhoids

作　　者：刘可文 周浩 王贵明 LIU Ke-wen;ZHOU Hao;WANG Gui-ming(Department of General Surgery,Ji′an Hospital,Shanghai Oriental Hospital,Jiangxi Province,Ji′an343000,China)

机构地区：[1]上海市东方医院吉安医院普外科,江西吉安343000

出　　处：《中国当代医药》2020年第10期94-96,共3页China Modern Medicine

基　　金：江西省吉安市指导性科技计划项目。

摘　　要：目的研究吻合器痔上黏膜环切术(PPH)联合超声刀治疗重度混合痔的临床效果。方法选取2018年6月~2019年5月我院收治的60例重度混合痔患者作为研究对象,采用摸球法分为A、B、C组,每组各20例。A组患者采用PPH联合超声刀治疗,B组患者采用PPH联合电刀治疗,C组患者采用PPH联合传统切除治疗。比较三组患者的手术时间、术中出血量、创面愈合时间、术后24 h疼痛评分及术后继发性出血、肛缘水肿、肛门狭窄等并发症的发生情况。结果 A组患者的手术时间及创面愈合时间均短于B组和C组,术中出血量少于B组和C组,B组患者的手术时间及创面愈合时间均短于C组,术中出血量少于C组,差异有统计学意义(P<0.05);A组患者术后24 h疼痛评分低于B组和C组,差异有统计学意义(P<0.05);A组患者的并发症总发生率低于B组和C组,差异有统计学意义(P<0.05)。结论 PPH联合超声刀治疗重度混合痔的临床效果显著,可有效控制术后并发症的发生风险及术中出血量,减少手术操作对机体健康造成的影响,具有较高的临床推广价值。Objective To study the clinical effect of stapler hemorrhoidectomy(PPH) combined with ultrasound scalpel in the treatment of severe mixed hemorrhoids. Methods Sixty patients with severe mixed hemorrhoids admitted to our hospital from June 20 to May 2019 were selected as the subjects. They were divided into group A, group B and group C by strokes, with 20 cases in each group. Group A was treated with PPH combined with ultrasonic scalpel, group B was treated with PPH combined with electrocautery, and group C was treated with PPH combined with conventional resection. The operation time, intraoperative blood loss, wound healing time, 24 h postoperative pain score and complications such as postoperative secondary hemorrhage, anal edema and anal stenosis were compared. Results The operation time and wound healing time in group A were shorter than those in group B and C, the intraoperative blood loss was less than that in group B and C, the operation time and wound healing time in group B were shorter than those in group C,the intraoperative blood loss was less than that in group C, and the differences were statistically significant(P<0.05).The 24 h pain score of group A was lower than that of group B and group C, and the differences were statistically significant(P<0.05). The total incidence of complications in group A was lower than that in group B and C, and the difference was statistically significant(P<0.05). Conclusion PPH combined with ultrasound scalpel has a significant clinical effect in the treatment of severe mixed hemorrhoids, which can effectively control the risk of complications and intraoperative bleeding, reduce the impact of surgical operation on the health of the body, and has a high clinical popularization value.

关 键 词：吻合器痔上黏膜环切术 超声刀 重度混合痔 并发症 疼痛评分 

分 类 号：R814.43[医药卫生—影像医学与核医学]