PPH结合内痔缝扎术治疗重度内痔的临床疗效  

Clinical efficacy of PPH combined with hemorrhoids ligation in the treatment of severe internal hemorrhoids

作　　者：魏欣 黄丹 胡发涌 杨传永 曹志新 Wei Xin;Huang Dan;Hu Fayong;Yang Chuanyong;Cao Zhixin(Department of Gastrointestinal Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院胃肠外科,湖北武汉430030

出　　处：《腹部外科》2020年第2期156-158,共3页Journal of Abdominal Surgery

摘　　要：目的探讨吻合器痔上黏膜环切术(procedure for prolapse and hemorrhoids,PPH)联合内痔痔核缝扎术治疗重度内痔的临床疗效。方法收集了2018年1月至2018年9月在同济医院光谷院区收治的Ⅲ度以上内痔病人共52例,按随机数字表法分为研究组(26例)和对照组(26例)。研究组行PPH联合内痔缝扎术,对照组仅行PPH,比较两组病人在术后1 d、3 d出血及术后肛门肿胀感及疼痛的变化,并在3个月后再次进行出血、排便困难和排便次数对比。结果研究组术后1 d、3 d及术后3个月的出血量显著少于对照组(P<0.05);两组术后1 d、3 d及术后3个月的疼痛评分差异无统计学意义(P>0.05);研究组术后肛门肿胀感与对照组间差异无统计学意义(P>0.05);3个月后两组病人排便困难和排便次数等差异无统计学意义(P>0.05)。结论PPH结合内痔缝扎术可以有效减少病人术后出血,同时不增加病人术后疼痛、肛门感觉异常和排便异常的现象,值得临床推广。Objective To explore the clinical efficacy of procedure for prolapse and hemorrhoids(PPH)combined with hemorrhoids ligation in the treatment of severe internal hemorrhoids.Methods A total of 52 patients with gradeⅢor higher internal hemorrhoids admitted to Guanggu Hospital of Tongji Hospital from January 2018 to September 2018 were randomly divided into experimental group(26 cases)and control group(26 cases).The experimental group underwent PPH combined with internal hemorrhoid suture ligation,and the control group underwent PPH only.The changes of bleeding,postoperative anal swelling sensation and pain at 1 d and 3 d after operation were compared between the two groups,and bleeding,defecation difficulty and defecation frequency were compared again after 3 months.Results The amount of bleeding in the experimental group was significantly less than that in the control group on the 1 st day,3 rd day and 3 rd month after operation(P<0.05).There was no significant difference in pain scores between the two groups at 1 st day,3 rd day and 3 rd month after operation(P>0.05);the postoperative anal swelling sensation was no statistical significance compared with control group(P>0.05).Three months later,there was no significant difference in defecation difficulty and frequency between the two groups(P>0.05).Conclusion PPH combined with internal hemorrhoids suture and ligation can effectively reduce postoperative bleeding without increasing postoperative pain,anorectal sensation and defecation abnormalities,which is worthy of clinical promotion.

关 键 词：吻合器痔上黏膜环切术 内痔缝扎 内痔 

分 类 号：R657.1[医药卫生—外科学]