应用负压吸引拉力式弹力线套扎器治疗脱垂性和出血性痔病303例的疗效分析  

Effect analysis of 303 cases with prolapse and hemorrhagic hemorrhoids treated by negative pressure suction of Ruiyun procedure

作　　者：司徒光伟 邹贤军 徐飞 周凯亮 刘国保 黄淦圣 陈燕 王晓玲 屈兵[2,3] SITU Guangwei;ZOU xianjun;XU Fei;ZHOU Kailiang;LIU Guobao;HUANG Gansheng;CHEN Yan;WANG Xiaoling;QU Bing(Dept.of Anorectal Surgery,the Eighth Hospital of Wuhan,Wuhan 430010,Hubei,China;China Resources&Wisco Genenral Hospital,Wuhan University of Science and Technology,Wuhan 430080,Hubei,China;Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]武汉市第八医院肛肠四科,湖北武汉430010 [2]武汉科技大学附属华润武钢总医院,湖北武汉430080 [3]武汉大学人民医院,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2021年第3期467-471,共5页Medical Journal of Wuhan University

基　　金：湖北省自然科学基金(编号:2016CFC718);吴阶平基金(编号:320.6750.16215);湖北省卫计委联合基金(编号:WJ2018H0051);武汉市卫生和计划生育委员会医学科研项目(编号:WX16D04)。

摘　　要：目的:了解负压吸引拉力式弹力线套扎器在治疗脱垂痔病中的治疗效果,建立新的套扎术在治疗脱垂性痔病的治疗体系。方法:采用回顾性分析方法,选择2016年1月—2018年6月我院诊断为脱垂Ⅱ、Ⅲ及Ⅳ型脱垂性痔病患者,采取新型负压吸引拉力式弹力线套扎器治疗。定期随访、收集术后设定各种数据,综合分析。结果:手术后住院时间最短4 d、最长21 d,平均8.7 d。疼痛评分:术后0~1 d无痛40例、2~3分242例、4~6分21例;术后2~3 d 2~3分189例;术后4~6 d 4~6分10例;术后9 d 4~6分2例。术后并发症:活动性出血5例、直肠狭窄5例、肛门狭窄0例、肛门增生肉芽78例、切口平均愈合时间(40.0±7.2)d。结论:弹力线套扎术能明显提升和固定脱垂性肛垫,合理缩减病理性肛垫。术中组织损伤小,出血少,术后并发症发生率较低,恢复工作时间快。与传统手术相比,能最大程度地保护肛门直肠组织结构,所有病例术后均达到治愈标准。Objective: To evaluate the therapeutic effect of negative pressure suction of Ruiyun procedure for hemorrhoids(RPH) in the treatment of prolapse hemorrhoids and to establish a new system of treatment for prolapse hemorrhoids.Methods: In this paper, a total of 303 patients who were diagnozed as Types Ⅱ, Ⅲ, and Ⅳ prolapsed hemorrhoids in our hospital from January 2016 to June 2018, were treated with negative pressure suction elastic wire ligator. All patients were followed up, and the outcomes were evaluated.Results: The shortest hospital stay after operation was 4 days and the longest was 21 days, with an average of 8. 7 days. By VAS scoring, only two cases showed medium post-operative pain after 9 days. Postoperative complications included active bleeding in 5 cases, rectal stenosis in 5 cases, anal stenosis in 3 cases, and anal hyperplastic granulation in 78 cases. The average healing time of incision was(40. 0±7. 2)days.Conclusion: Elastic wire ligation has obvious effect of lifting and fixing prolapsed anal pad, which can reasonably reduce the pathological anal pad. The results showed that this operative method could lessen damages, reduce hemorrhage during operation and post-operative pain, and promote the recovery. It preserves maximum anus-rectum tissue structure much better as compared with the traditional surgical procedures.

关 键 词：负压吸引 拉力式弹力线套扎器 脱垂性和出血性痔病 

分 类 号：R657.18[医药卫生—外科学]