外剥内扎术与吻合器痔上黏膜环切术治疗混合痔患者的临床疗效比较  

Comparison on the clinical efficacy of Milligan-Morgan hemorrhoidectomy and procedure for prolapse and hemorrhoids in the treatment of mixed hemorrhoids patients

作　　者：王鑫[1] WANG Xin(Department of General Surgery,Shenyang Tenth People’s Hospital,Shenyang 110044,China)

机构地区：[1]沈阳市第十人民医院普外科,110044

出　　处：《中国实用医药》2022年第5期39-41,共3页China Practical Medicine

摘　　要：目的 探究外剥内扎术(MMH)与吻合器痔上黏膜环切术(PPH)治疗混合痔患者的临床疗效。方法 86例混合痔手术患者,依据随机数字表法分为对照组与观察组,各43例。对照组采用MMH治疗,观察组采用PPH治疗。比较两组手术及术后康复相关指标、术后并发症发生情况,随访1年,比较两组复发情况及肛门功能。结果 观察组手术时间(32.00±7.48)min、术后持续疼痛时间(1.85±0.37)d、住院时间(3.59±1.04)d均短于对照组的(37.12±6.35)min、(2.84±0.49)d、(4.90±1.15)d,术中出血量(7.33±2.11)ml少于对照组的(15.21±4.96)ml,差异有统计学意义(P<0.05)。观察组术后并发症发生率11.63%低于对照组的32.56%,差异有统计学意义(P<0.05)。术后1年,观察组复发率2.33%低于对照组的13.95%,差异有统计学意义(P<0.05)。术后1年,观察组患者肛管高压带长度长于对照组,肛管静息压、直肠肛门抑制反射阳性率均高于对照组,差异有统计学意义(P<0.05)。两组直肠静息压、肛管最大收缩压比较,差异无统计学意义(P>0.05)。结论 在对混合痔患者手术治疗中,与MMH相比, PPH可显著改善患者手术相关指标,降低术后并发症发生率,且远期肛门功能理想,复发率更低,具推广价值。Objective To investigate the clinical efficacy of Milligan-Morgan hemorrhoidectomy(MMH)and procedure for prolapse and hemorrhoids(PPH)in the treatment of mixed hemorrhoids patients.Methods According to the random numerical table,86 patients with mixed hemorrhoid were divided into control group and observation group,with 43 cases in each group.The control group was treated with MMH,and the observation group was treated with PPH.Both groups were compared in terms of surgery and postoperative rehabilitation related indicators,postoperative complications,recurrence and anal function at 1 year after surgery.Results The operation time(32.00±7.48)min,postoperative pain duration(1.85±0.37)d,and hospitalization time(3.59±1.04)d of the observation group were shorter than(37.12±6.35)min,(2.84±0.49)d,and(4.90±1.15)d of the control group;the intraoperative blood loss(7.33±2.11)ml of the observation group was less than(15.21±4.96)ml of the control group;all the differences were statistically significant(P<0.05).The postoperative complication rate 11.63%of the observation group was lower than 32.56%of the control group,and the difference was statistically significant(P<0.05).1 year after surgery,the recurrence rate 2.33%of the observation group was lower than 13.95%of the control group,and the difference was statistically significant(P<0.05).1 year after surgery,the length of anal high pressure zone of the observation group was longer than that in the control group,and the anal resting pressure and positive rate of anorectal inhibitory reflex in the observation group were higher than those in the control group.All the difference was statistically significant(P<0.05).There was no statistically significant difference in rectal resting pressure and anal maximum systolic pressure between the two groups(P>0.05).Conclusion In the surgical treatment of patients with mixed hemorrhoids,compared with MMH,PPH can significantly improve the surgical related indicators,reduce the postoperative complication rates,and the long-term ana

关 键 词：混合痔 外剥内扎术 吻合器痔上黏膜环切术 

分 类 号：R657.18[医药卫生—外科学]