痔上黏膜环切术加外痔分段切除血栓剥离治疗急性嵌顿性混合痔的效果观察  

Effect observation of procedures for prolapse and hemorrhoids and excision for thrombosed external hemorrhoid in acute incarcerated mixed hemorrhoids

作　　者：胡江林 朱静芳 袁海涛 邓明 童端 周凯亮 HU Jianglin;ZHU Jingfang;YUAN Haitao(Department of Surgery Three Branches,Hubei Province Wuhan City East Lake Area People's Hospital,Wuhan 420102,China)

机构地区：[1]湖北省武汉市东西湖区人民医院外三科,420102 [2]湖北省武汉市东西湖区人民医院产科,420102 [3]武汉市第八医院外科

出　　处：《临床外科杂志》2020年第3期263-265,共3页Journal of Clinical Surgery

基　　金：2017年湖北省卫生计委指导性资助项目(WJ2017F027)。

摘　　要：目的分析急性嵌顿性混合痔病人采用痔上黏膜环切术(PPH)联合外痔分段切除血栓剥离治疗的临床效果。方法 2014年9月~2018年5月间我院收治的急性嵌顿性混合痔病人82例,根据治疗方法不同将其分为两组,对照组41例,实施外剥内扎术治疗;观察组41例,实施PPH联合外痔分段切除血栓剥离治疗。比较两组的手术情况、并发症和疗效。结果观察组治疗总有效率为95.12%,明显高于对照组的85.37%,差异有统计学意义(P<0.05)。两组病人手术时间、出血量比较,差异无统计学意义(P>0.05);观察组住院时间和愈合时间均短于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为2.44%,明显低于对照组的19.51%,差异有统计学意义(P<0.05)。两组术前VAS评分比较无差异,术后3小时、12小时、24小时的评分明显低于术前,且观察组术后3小时、12小时、24小时评分低于对照组,差异有统计学意义(P<0.05)。结论 PPH联合外痔分段切除血栓剥离治疗急性嵌顿性混合痔效果较好,病人住院时间短,并发症发生率低,快速减轻疼痛。Objective To study the clinical effect of procedures for prolapse and hemorrhoids(PPH)and excision for thrombosed external hemorrhoid in acute incarcerated mixed hemorrhoids.Methods 82 acute incarcerated mixed hemorrhoids patients treated from September 2014 to May 2018 in our hospital were selected and randomly assigned to two groups,41 cases each group.The control group was treated with Milligan-Morgan surgery;the observation group was treated with PPH plus excision for thrombosed external hemorrhoid.The therapeutic effect,operation conditions and complications were probed.Results The total effective rate in the observation group(95.12%)was significantly higher than control group(85.37%)(P<0.05);the operation time and bleeding volume showed no significant differences(P>0.05);the hospitalization time and wound healing time in the observation group was shorter than control group(P<0.05);the incidence rate of complications in the observation group(2.44%)was significantly lower than control group(19.51%)(P<0.05).There was no difference in VAS scores between the two groups before operation.The scores of 3 hours,12 hours and 24 hours after operation were significantly lower than those before operation,and the scores of 3 hours,12 hours and 24 hours after operation in the observation group were lower than those in the control group(P<0.05).Conclusion The procedures for prolapse and hemorrhoids plus excision for thrombosed external hemorrhoid can remarkably increase the effective rate,shorten the hospitalization time and wound healing time,and reduce the incidence rate of complications.

关 键 词：痔上黏膜环切术 外痔分段切除血栓剥离 急性嵌顿性混合痔 

分 类 号：R657.18[医药卫生—外科学]