不同手术方式治疗Ⅲ、Ⅳ度脱垂性混合痔的效果比较  

Comparison of the Effects of Different Surgical Methods in the Treatment of Grade Ⅲ and Grade Ⅳ Prolapsed Mixed Hemorrhoids

作　　者：侯松涛 张俊仲 HOU Song-tao;ZHANG Jun-zhong(Department of Anorectal,Tianjin Binhai New Area Traditional Chinese Medicine Hospital,Tianjin 300451,China)

机构地区：[1]天津市滨海新区中医医院肛肠科,天津300451

出　　处：《医学信息》2021年第18期113-115,共3页Journal of Medical Information

基　　金：2018年天津市滨海新区卫生计生委科技项目(编号:2018BWKQ031)。

摘　　要：目的比较外剥内扎手术、痔上黏膜C环切除手术和痔上黏膜环形切除钉合手术治疗Ⅲ、Ⅳ度脱垂性混合痔的疗效。方法选取2015年1月-2017年12月我院肛肠科收治的脱垂性混合痔患者435例作为研究对象,按照手术方式不同分为甲组185例、乙组152例和丙组98例,分别给予外剥内扎手术、痔上黏膜C环切除手术和痔上黏膜环形切除钉合手术治疗,比较三组临床疗效、围术期临床指标及预后情况。结果甲组治疗总有效率低于乙组、丙组(P<0.05);而乙组、丙组治疗总有效率比较,差异无统计学意义(P>0.05)。甲组手术时间、住院天数长于乙组、丙组,手术满意度评分低于乙组、丙组,术后疼痛评分高于乙组、丙组(P<0.05);而乙组、丙组相关围术期指标比较,差异无统计学意义(P>0.05)。甲组疾病复发率、肛门狭窄发生率、术后出血率、再入院率均高于乙组、丙组(P<0.05);而乙组和丙组预后相关指标比较,差异无统计学意义(P>0.05)。结论外剥内扎手术、痔上黏膜C环切除手术和痔上黏膜环形切除钉合手术三种术式均能有效治疗Ⅲ、Ⅳ度脱垂性混合痔,但相较而言,痔上黏膜C环切除手术和痔上黏膜环形切除钉合手术的临床疗效更为理想,术后并发症发生率更低,预后效果更好。Objective To compare the clinical effects of external stripping and internal ligation,C-ring resection of the hemorrhoids,and circular resection and nailing of the hemorrhoids in the treatment of grade Ⅲ and grade Ⅳ prolapsed mixed hemorrhoids.Methods A total of 435 patients with prolapsed mixed hemorrhoids admitted to our hospital from January 2015 to December 2017 were selected as the research objects.According to the different surgical methods,they were divided into 185 cases in group A,152 cases in group B,and 98 cases in group C.They were treated with external dissection and internal ligation,C-ring resection of the hemorrhoids,and ring resection and nailing of the hemorrhoids.The clinical efficacy,perioperative clinical indicators and prognosis of the three groups were compared.Results The total effective rate of treatment in group A was lower than that in groups B and C(P<0.05),while there was no statistically significant difference in the total effective rate of treatment between group B and group C(P>0.05).The operation time and length of hospital stay in group A were longer than those in groups B and C,the surgical satisfaction scores were lower than those in groups B and C,the postoperative pain scores were higher than those in groups B and C(P<0.05),while there was no statistically significant difference in related perioperative indicators between group B and group C(P>0.05).The disease recurrence rate,anal stenosis rate,postoperative bleeding rate,and readmission rate in group A were higher than those in groups B and C(P<0.05),while there was no statistically significant difference in prognostic indicators between groups B and C(P>0.05).Conclusion The three surgical methods of external stripping and internal ligation,C-ring resection of the hemorrhoids,and circular resection and nailing of the hemorrhoids can effectively treat gradeⅢandⅣprolapsed mixed hemorrhoids.However,in comparison,the C-ring resection of the hemorrhoids and the circular resection and nailing of the hemorrhoids have bette

关 键 词：脱垂性混合痔 痔上黏膜C环切除术 外剥内扎手术 痔上黏膜环形切除钉合手术 

分 类 号：R657.18[医药卫生—外科学]