锯齿状自动弹力线套扎加外痔切缝术治疗Ⅱ~Ⅳ度混合痔临床观察  

Clinical observation on the treatment of mixed hemorrhoids of degreeⅡ~Ⅳ with using RPH-4 to form zigzag line for binding point connection combined with external hemorrhoidectomy and suture

作　　者：曹亮 王剑新 沈秋菊 韩娟 金顺德 金淳民 Cao Liang;Wang Jianxin;Shen Qiuju;Han Juan;Jin Shunde;Jin Chunmin(Anorectal Department of Suzhou Integrated Traditional Chinese and Western Medicine Hospital,Suzhou 215101,China)

机构地区：[1]苏州市中西医结合医院肛肠科,215101

出　　处：《中华结直肠疾病电子杂志》2020年第5期512-516,共5页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：苏州市中西医结合医院院级课题(No.YJ2019001)。

摘　　要：目的对比锯齿状自动弹力线套扎加外痔切缝术(文中简称"锯齿状RPH-4")与痔上黏膜环切术(PPH)治疗Ⅱ~Ⅳ度混合痔的临床效果。方法纳入2018年4月至2020年4月苏州市中西医结合医院肛肠科收治的120例Ⅱ~Ⅳ度混合痔患者作为研究对象,按随机数字表法分为治疗组和对照组,每组60例。治疗组行锯齿状RPH-4自动弹力线套扎加外痔切缝术,几个套扎点位按顺序连线呈锯齿状,对照组行PPH术。比较两组患者手术时间、术中出血量、住院时间及术后并发症等情况。结果治疗组与对照组的手术时间(t=-9.351,P<0.05)、术中出血量(t=-18.571,P<0.05)、住院时间(t=-4.471,P<0.05)、术后并发症经比较差异均有统计学意义[疼痛(术后第1天:t=-15.879,P<0.05;术后第3天:t=-3.901,P<0.05),出血(术后第1天:t=-6.914,P<0.05;术后第3天:t=-2.335,P<0.05),水肿(术后第1天:t=-4.068,P<0.05;术后第3天:t=-4.424,P<0.05)]。总有效率:治疗组为98.3%、PPH组为93.3%,差异有统计学意义(χ^2=8.26,P<0.05)。结论锯齿状RPH-4加外痔切缝术在治疗Ⅱ~Ⅳ度混合痔上明显优于PPH术,能安全、快速、有效的缓解临床症状,更有利于患者术后康复,值得临床推广。Objective To compare the clinical effect of using RPH-4 to form zigzag line for binding point connection Combined with external hemorrhoidectomy and suture and PPH in the treatment of mixed hemorrhoids with gradeⅡ~Ⅳ.Methods From April 2018 to April 2020,120 patients with mixed hemorrhoids of gradeⅡ~Ⅳwere included in Anorectal Department of Suzhou Integrated Traditional Chinese and Western Medicine Hospital as the study object,and randomly divided into treatment group and control group,sixty cases in each group.Serrated ligation with RPH-4 was performed in the treatment group and PPH in the control group.Results The treatment group of the operation time(t=-9.351,P<0.05),intraoperative bleeding volume(t=-18.571,P<0.05),hospitalization time(t=-4.471,P<0.05),postoperative complications were significantly better than control group[pain(The first day after operation:t=-15.879,P<0.05;the third day after operation:t=-3.901,P<0.05),hemorrhage(The firstday after operation:t=-6.914,P<0.05;the third day after operation:t=-2.335,P<0.05),edema(The first day after operation:t=-4.068,P<0.05;the third day after operation:t=-4.424,P<0.05)].Total effective rate of the treatment group(98.3%)were significantly better than those of the control group(93.3%)(χ^2=8.26,P<0.05).Conclusion Automatic ligation is superior to hemorrhoid mucosal circumcision in the treatment of gradeⅡ~Ⅳmixed hemorrhoids.It is safe,rapid and effective in relieving clinical symptoms,and is more conducive to postoperative rehabilitation.It is worthy of clinical promotion.

关 键 词：痔 肛门疾病 自动弹力线套扎 痔上黏膜环切术 

分 类 号：R657.18[医药卫生—外科学]