外痔剥离皮瓣整形结合内痔悬吊术治疗Ⅱ~Ⅳ期混合痔的效果分析  

Analysis of the effect of external hemorrhoids stripping skin flap plastic surgery combined with internal hemorrhoids suspension surgery in the treatment of patients with stageⅡ-Ⅳmixed hemorrhoids

作　　者：王湛辉 邹小文 张小燕 WANG Zhan-hui;ZOU Xiao-wen;ZHANG Xiao-yan(Nanao People's Hospital,Dapeng New District,Shenzhen 518120,China)

机构地区：[1]广东省深圳市大鹏新区南澳人民医院,广东深圳518120

出　　处：《实用医院临床杂志》2021年第5期184-187,共4页Practical Journal of Clinical Medicine

基　　金：深圳市大鹏新区科技创新和产业发展基金项目(编号YL202001-15)。

摘　　要：目的研究外痔剥离皮瓣整形结合内痔悬吊术对Ⅱ~Ⅳ期混合痔患者的效果。方法选取2019年12月至2020年12月在我院就诊的Ⅱ~Ⅳ期混合痔患者50例,按照治疗方式的不同分为对照组和研究组各25例。对照组采用外痔切除内痔缝扎术联合肛肠治疗仪治疗,研究组采用外痔剥离皮瓣整形术结合内痔悬吊术治疗。分别于术前、术后3、7天检测患者应激相关指标C反应蛋白(CRP)、皮质醇(COR)、促肾上腺皮质激素(ACTH),比较两组手术指标、创面愈合情况、术后并发症及治疗有效率。结果与术前比较,两组患者术后3、7天应激相关指标的水平均升高。与对照组比较,研究组术后3、7天应激相关指标的水平均降低;术后术中失血量减少,手术时间、住院时间、切口愈合时间、创面愈合时间、创面腐肉脱落时间缩短,术后7天并发症总发生率降低,创面缩小率、术后1个月总有效率均升高,差异均有统计学意义(P<0.05)。结论外痔剥离皮瓣整形结合内痔悬吊术治疗Ⅱ~Ⅳ期混合痔患者的效果显著,值得临床应用及推广。Objective To investigate the effect of external hemorrhoidsstripping skin flap plastic surgery combined with internal hemorrhoids suspensionsurgeryin the treatment of stage II~IV mixed hemorrhoids.Methods From December 2019 to December 2020,50 patients with stage II~IV mixed hemorrhoids were selected.According to the different treatment methods,the patients were divided into control group and study group,25 in each group.The control group was treated with external hemorrhoidectomy and internal hemorrhoid sutureligationcombined with anorectal treatment instrument while the study group was treated with external hemorrhoids stripping skin flap plastic surgery combined with internal hemorrhoids suspension surgery.Stress-related indicators such as C reactive protein(CRP),cortisol(COR)and adrenocorticotropic hormone(ACTH)were measured before and after 3 and 7 days of operation.The operative indexes,wound healing,postoperative complications and effective rate of treatment were compared between the two groups.Results Compared to before treatment,the levels of stress-related indexes were increased after 3 and 7 days of operation in both groups.Compared with the control group,the levels of stress-related indexes were decreased in the study group after 3 and 7 days of operation.Compared with the control group,postoperativeand intraoperative blood loss,operation time,hospital stay,incision healing time,wound healing time,wound carrion off time and total incidence of complications after 7 days of operation were reduced.The wound reduction rate and the total effective rate after 1 month of operation were increased.All differences were statistically significant(P<0.05).Conclusion External hemorrhoids peeling flap plastic surgery combined with internal hemorrhoids suspensionsurgery in the treatment of stage II~IV mixed hemorrhoids patients have a good effect.It is worthy of clinical application and promotion.

关 键 词：外痔剥离皮瓣整形 内痔悬吊术 Ⅱ~Ⅳ期混合痔 并发症 

分 类 号：R69[医药卫生—泌尿科学]