选择性痔上黏膜切除吻合术与外切内扎术治疗Ⅱ、Ⅲ期混合痔患者的效果比较  

Comparison of effects of tissue-selecting therapy stapler and external dissection and internal ligation in treatment of patients with stage Ⅱ and Ⅲ mixed hemorrhoids

作　　者：贺俊[1] 吴奂镒 HE Jun;WU Huanyi(First Department of anorectal Hospital of Jiamusi City,Jiamusi 154000 Heilongjiang,China)

机构地区：[1]佳木斯市肛肠医院一科,黑龙江佳木斯154000

出　　处：《中国民康医学》2022年第9期132-135,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较选择性痔上黏膜切除吻合术(TST)与外切内扎术治疗Ⅱ、Ⅲ期混合痔患者的效果。方法:选取200例Ⅱ、Ⅲ期混合痔患者为研究对象,按随机数字表法将其分为观察组与对照组各100例。观察组采用TST治疗,对照组采用外切内扎术治疗,比较两组治疗效果、治疗前后肛肠动力学指标[肛管最大收缩压(MSP)、肛管静息压(ARP)]水平、术后疼痛程度[视觉模拟评分法(VAS)]评分、手术时间、术中出血量和术后并发症发生率。结果:两组治疗总有效率比较,差异无统计学意义(P>0.05);术后,两组MSP、ARP水平均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组术后VAS评分为(1.35±0.52)分,低于对照组的(2.09±0.71)分,差异有统计学意义(P<0.05);观察组术后并发症发生率为6.00%(6/100),低于对照组的17.00%(17/100),差异有统计学意义(P<0.05)。结论:TST治疗Ⅱ、Ⅲ期混合痔患者可提高肛肠动力学指标水平,降低VAS评分和术后并发症发生率,效果优于外切内扎术治疗。Objective:To compare effects of tissue-selecting therapy stapler(TST)and external dissection and internal ligation in treatment of patients with stage Ⅱ and Ⅲ mixed hemorrhoids.Methods:200 patients with stage Ⅱ and Ⅲ mixed hemorrhoids were selected as the research objects,and were divided into observation group and control group according to the random number table method,100 cases in each.The observation group was treated with TST,while the control group was treated with external dissection and internal ligation.The treatment effects,the anorectal dynamic index levels[maximal systolic pressure of the anal canal(MSP),resting pressure of the anal canal(ARP)],the postoperative pain degree[visual analogue scale(VAS)]score,the operation time,the intraoperative blood loss and the postoperative complication rate were compared between the two groups.Results:There was no significant difference in the total effective rate of treatment between the two groups(P>0.05).After the surgery,the levels of MSP and ARP in the two groups were higher than those before the surgery;those of the observation group were higher than those of the control group;and the differences were statistically significant(P<0.05).The postoperative VAS score of the observation group was(1.35±0.52),which was lower than the control group of(2.09±0.71),and the difference was statistically significant(P<0.05).Further,the incidence of postoperative complications in the observation group was 6.00%(6/100),which was lower than 17.00%(17/100)in the control group,and the difference was statistically significant(P<0.05).Conclusions:TST in the treatment of stage Ⅱ and Ⅲ mixed hemorrhoids can improve the levels of anorectal dynamic indexes and reduce the VAS score and the incidence of postoperative complications.Moreover,it is superior to external dissection and internal ligation.

关 键 词：混合痔 Ⅱ、Ⅲ期 选择性痔上黏膜切除吻合术 外切内扎术 肛肠动力学 并发症 

分 类 号：R657.1[医药卫生—外科学]