痔上黏膜次环切吻合术与PPH术治疗脱垂性混合痔的临床效果比较分析  

Comparing hemorrhoid partial stapling and procedure for prolapse and hemor⁃rhoids for treating prolapsed mixed hemorrhoids

作　　者：白凤全 傅文斌 黄安清[2] 杨超[2] Bai Fengquan;Fu Wenbin;Huang Anqing;Yang Chao(Department of Anorectal Diseases,Chengdu Jinsha Hospital,Chengdu 610091,Sichuan,China;Department of Traditional Chinese Medicine,Sichuan Provincial People’s Hospital,Chengdu 610072,Sichuan,China)

机构地区：[1]成都金沙医院肛肠科,四川成都610091 [2]四川省人民医院中医科,四川成都610072

出　　处：《结直肠肛门外科》2020年第5期584-588,共5页Journal of Colorectal & Anal Surgery

摘　　要：目的对比分析痔上黏膜次环切吻合术与PPH术治疗脱垂性混合痔的临床效果。方法纳入2019年9月至2019年11月在四川省人民医院中医科就诊并拟行手术治疗的脱垂性混合痔患者为研究对象,采用随机数字表法将患者分为观察组(n=82,采用痔上黏膜次环切吻合术)和对照组(n=82,采用PPH术)。比较两组临床疗效,手术切除标本的重量、容量、表面积,术后切口疼痛、肛门坠胀、吻合口狭窄等并发症的差异。结果两组临床疗效(术后1个月和3个月)、切除标本的重量、容量、表面积比较差异均无统计学意义(均P>0.05)。术后第3天和第7天,观察组切口疼痛程度均轻于对照组,差异有统计学意义(均P<0.05);术后第14天和第30天,两组切口疼痛程度比较差异均无统计学意义(均P>0.05)。术后第3天、第7天及第14天,观察组肛门坠胀程度均轻于对照组,差异有统计学意义(均P<0.05);术后第30天,两组肛门坠胀程度比较差异无统计学意义(P>0.05)。术后1个月,观察组直肠吻合口狭窄程度轻于对照组,差异有统计学意义(P<0.05)。结论痔上黏膜次环切吻合术治疗脱垂性混合痔患者,能达到与PPH术相似的临床治疗效果,同时在术后恢复过程中,能减轻切口疼痛、肛门坠胀、吻合口狭窄等并发症严重程度,值得临床研究及推广应用。Objectives To compare the therapeutic effect of hemorrhoid partial stapling and procedure for prolapse and hemor⁃rhoids(PPH)for treating prolapsed mixed hemorrhoids.Methods Patients with prolapsed mixed hemorrhoids at the Department of Traditional Chinese Medicine,Sichuan Provincial People’s Hospital,between September and November 2019 were recruited.They were randomly assigned to the treatment group(n=82,received hemorrhoid partial stapling)and control group(n=82,re⁃ceived PPH).The followings were compared between the two groups:clinical effectiveness,weight,volume and surface area of the resection specimens,postoperative pain,and incidence of anal bulge and anal stenosis.Results The two groups did not dif⁃fer in clinical effectiveness(at 1 and 3 months postoperative)and weight,volume and surface area of the resection specimens(P>0.05).Pain at 3 and 7 days postoperative was significantly less in the treatment group than in the control group(P<0.05).but pain at 14 and 30 days postoperative was similar between the two groups(P>0.05).The severity of anal bulge at 3,7,and 14 days postoperative was also significantly less in the treatment group(P<0.05),but the severity of anal bulge at 30 days postopera⁃tive was similar between the two groups(P>0.05).The severity of anal stenosis at 1 month postoperative was significantly less in the treatment group(P<0.05).Conclusion Both treatments are effective in treating prolapsed mixed hemorrhoids.However,hemor⁃rhoid partial stapling can alleviate pain and decrease complications such as anal bulge and anal stenosis.It has the potential for wider clinical application.

关 键 词：脱垂性混合痔 痔上黏膜次环切吻合术 PPH术 

分 类 号：R657.18[医药卫生—外科学]