TST术联合聚桂醇注射术与PPH术治疗Ⅱ~Ⅳ度混合痔患者的临床效果比较分析  

Comparison of tissue selecting technique combined with Lauromacrogol injection and procedure for prolapsing hemorrhoids for gradeⅡ~Ⅳmixed hemorrhoids

作　　者：张晓飞 李华山[2] 黄德荣 刘歆 卢彦 Zhang Xiaofei;Li Huashan;Huang Derong;Liu Xin;Lu Yan(Department of Anorectal Diseases,Ganzhou Hospital of Traditional Chinese Medicine,Ganzhou 341000,Jiangxi,China;Department of Anorectal Diseases,China Academy of Chinese Medical Sciences Guang’anmen Hospital,Beijing 100053,China)

机构地区：[1]赣州市中医院肛肠科,江西赣州341000 [2]中国中医科学院广安门医院肛肠科,北京100053

出　　处：《结直肠肛门外科》2020年第3期350-353,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的对比分析TST术联合聚桂醇注射术与PPH术治疗Ⅱ~Ⅳ度混合痔患者的临床效果。方法选择2016年12月至2019年10月赣州市中医院就诊的238例Ⅱ~Ⅳ度混合痔患者为研究对象,采用密闭信封法将患者随机分为观察组(n=119,采用TST术联合聚桂醇注射术)和对照组(n=119,采用PPH术),比较两组术后创面疼痛、水肿程度和肛门坠胀评分、肛门狭窄发生情况、尿潴留发生情况、总体满意度、医疗费用及疗效。结果两组有效率均为100%。观察组治愈率为92.4%,高于对照组的71.4%(P<0.001);观察组临床疗效优于对照组(P<0.05)。术后8 h,两组疼痛评分比较差异无统计学意义(P>0.05);术后24 h、48 h、72 h观察组疼痛评分均低于对照组(均P<0.05)。术后第2天、第4天,观察组水肿评分均低于对照组(均P<0.05)。术后第2天,两组肛门坠胀评分比较差异无统计学意义(P>0.05)。术后第4天、第30天,观察组肛门坠胀评分均低于对照组(均P<0.05)。观察组术后无肛门狭窄情况发生,术后尿潴留发生率低于对照组,观察组总体满意度优于对照组(均P<0.05)。两组医疗费用比较差异无统计学意义(P>0.05)。结论与PPH术相比,TST术联合聚桂醇硬化剂注射术治疗Ⅱ~Ⅳ度混合痔患者的临床效果较好,并发症少,患者满意度高,不增加医疗费用,值得临床推广使用。Objectives To compare the efficacy of tissue selecting technique(TST)combined with Lauromacrogol injection and procedure for prolapsing hemorrhoids(PPH)for gradeⅡ~Ⅳmixed hemorrhoids.Methods A total of 238 patients with gradeⅡ~Ⅳmixed hemorrhoids treated at Ganzhou Hospital of Traditional Chinese Medicine between December 2016 and October 2019 were recruited.Patients were randomly assigned to treatment group(n=119)and control group(n=119)using sealed envelopes.The treatment group received TST combined with Lauromacrogol injection,and the control group received PPH.Postoperative wound pain score,edema,and anal distension,anal stricture,the incidence of urinary retention,patients’overall satisfaction,medical expenses,and effectiveness were compared between the two groups.Results Although the effective rate was 100%in both groups,more patients were cured in the treatment group than in the control group(92.4%vs.71.4%,P<0.001).The overall effectiveness was better in the treatment group(P<0.05).There were no significant differences between the two groups in pain score at 8 hours after surgery(P>0.05).Pain scores at 24,48,and 72 hours after surgery were significantly lower in the treatment group than in the control group(P<0.05).Edema scores at 2 and 4 days after surgery were also significantly lower in the treatment group(P<0.05).The two groups did not differ in anal distension score at 2 days after surgery(P>0.05),but anal distension scores at 4 and 30 days after surgery were significantly lower in the treatment group(P<0.05).No anal stricture occurred and the incidences of urinary retention were significantly lower,and patients’satisfaction was significantly better in the treatment group(P<0.05).Medical expenses did not differ between the two groups(P>0.05).Conclusion Compared with PPH,TST combined with Lauromacrogol injection is more effective in treating gradeⅡ~Ⅳmixed hemorrhoids.It is associated with fewer complications and good patients’satisfaction and does not increase medical expenses.It has th

关 键 词：混合痔 选择性痔上黏膜切除术 聚桂醇 痔上黏膜环切吻合术 

分 类 号：R657.18[医药卫生—外科学]