Milligan-Morgan手术联合痔动脉结扎术在Ⅲ~Ⅳ度混合痔治疗中的应用  

Milligan-Morgan procedure combined with hemorrhoidal artery ligation in the treatment of Ⅲ-Ⅳ degree mixed hemorrhoids

作　　者：李斌 李轩 张琼 赵文鹏 LI Bin;LI Xuan;ZHANG Qiong;ZHAO Wenpeng(Department of Surgery Ⅱ,Gansu Corps Hospital of the Chinese Armed Police Forces,Gansu,Lanzhou 730050,China;Department of Internal Medicine Ⅰ,Gansu Corps Hospital of the Chinese Armed Police Forces,Gansu,Lanzhou 730050,China)

机构地区：[1]武警甘肃省总队医院外二科,甘肃兰州730050 [2]武警甘肃省总队医院内一科,甘肃兰州730050

出　　处：《中国医药科学》2022年第8期133-136,163,共5页China Medicine And Pharmacy

摘　　要：目的观察Milligan-Morgan手术联合痔动脉结扎术在治疗Ⅲ~Ⅳ度混合痔中的临床疗效。方法纳入2020年1—10月在武警甘肃省总队医院外二科收治的56例Ⅲ~Ⅳ度混合痔患者作为研究对象,将患者随机分为观察组(n=28)和对照组(n=28),观察组采用Milligan-Morgan手术联合痔动脉结扎术,对照组采用传统Milligan-Morgan手术。比较两组术中指标、术后并发症及复发情况。结果两组患者手术时间比较,差异无统计学意义(P>0.05),观察组术中出血量少于对照组,差异有统计学意义(P<0.05);两组在术后第1、3、7天疼痛评分比较,差异无统计学意义(P>0.05);观察组术后出血及肛缘水肿发生率低于对照组,差异有统计学意义(P<0.05);两组患者术后尿潴留及1年复发率比较差异无统计学意义(P>0.05)。结论采用Milligan-Morgan手术联合痔动脉结扎术治疗Ⅲ~Ⅳ混合痔与传统Milligan-Morgan手术相比,能显著减少术中出血量,减少术后出血及肛缘水肿发生率;联合术式并不增加手术时间、患者术后疼痛程度及尿潴留发生率。Objective To observe the clinical efficacy of Milligan-Morgan procedure combined with hemorrhoidal artery ligation in the treatment of Ⅲ-Ⅳ degree mixed hemorrhoids.Methods A total of 56 patients with Ⅲ-Ⅳ degree mixed hemorrhoids admitted to the Department of Surgery Ⅱ in the Gansu Provincial Corps Hospital of Chinese People’s Armed Police Forces from January 2020 to October 2020 were included as study subjects.These patients were randomly divided into the observation group(n=28)and the control group(n=28).The observation group was treated with Milligan-Morgan procedure combined with hemorrhoidal artery ligation,while the control group was treated with traditional Milligan-Morgan procedure only.The two groups were compared in terms of intraoperative indicators,postoperative complications and relapse.Results There was no statistically significant difference between the two groups in surgical duration(P>0.05).The intraoperative bleeding volume in the observation group was less than that in the control group,with statistically significant difference(P<0.05).There were no statistically significant differences between the two groups in the pain level on the first,third and seventh postoperative days(P>0.05).The incidences of postoperative bleeding and anal edge edema in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).There were no statistically significant differences between the two groups in terms of the incidence of postoperative urina ry retention and the 1-year relaps e rate(P>0.05).Conclusion Compared with the traditional Milligan-Morgan procedure,the combination of Milligan-Morgan procedure and hemorrhoidal artery ligation can more significantly reduce intraoperative bleeding volume and the incidences of postoperative bleeding and anal edge edema in the treatment of Ⅲ-Ⅳ mixed hemorrhoids.In addition,such a combination does not increase the surgical duration as well as the pain level and the incidence of urinary retention after su

关 键 词：混合痔 痔切除术 MILLIGAN-MORGAN 痔动脉结扎术 

分 类 号：R657.18[医药卫生—外科学]