吻合器痔上黏膜环切术联合悬吊固定术治疗重度痔并内脱垂的近远期疗效及并发症观察  

Observation on Short-term and Long-term Efficacy and Complications of Procedure for Prolapse and Hemorrhoids Combined with Suspension Fixation in the Treatment of Severe Hemorrhoids with Internal Prolapse

作　　者：耿绪旺 GENG Xu-wang(Department of General Surgery,the People's Hospital of Jizhou District,Tianjin 301900,China)

机构地区：[1]天津市蓟州区人民医院普外科,天津301900

出　　处：《医学信息》2023年第16期129-132,共4页Journal of Medical Information

摘　　要：目的观察吻合器痔上黏膜环切术联合悬吊固定术治疗重度痔并内脱垂的近远期疗效及并发症。方法选取2020年1月-2022年1月在我院诊治的120例重度痔并内脱垂患者为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组采用吻合器痔上黏膜环切术治疗,观察组在对照组基础上联合悬吊固定术,比较两组近期治疗疗效、临床手术指标、术后24 h疼痛评分和首次排便疼痛评分、肛门功能指标(肛门坠胀及排便评分、肛管静息压、肛管最大收缩压)、并发症发生率、复发率。结果观察组治疗总有效率为95.00%,高于对照组的80.00%(P<0.05);观察组手术时间长于对照组,术中出血量少于对照组,切口愈合时间、住院时间均短于对照组(P<0.05);观察组术后24 h疼痛评分、首次排便疼痛评分、肛门坠胀及排便评分、肛管静息压、肛管最大收缩压均低于对照组(P<0.05);观察组并发症发生率为6.67%,低于对照组的18.33%(P<0.05);随访6个月,观察组复发率为1.67%,低于对照组的11.67%(P<0.05)。结论重度痔并内脱垂患者采用吻合器痔上黏膜环切术联合悬吊固定术治疗手术时间长,但是可提高疗效,减少术中出血量,减轻患者创伤,缩短术后切口愈合和住院时间,减轻患者疼痛评分,促进肛门功能恢复,降低并发症发生率和复发率,具有良好的近远期疗效,值得临床应用。Objective To observe the short-term and long-term efficacy and complications of procedure for prolapse and hemorrhoids combined with suspension fixation in the treatment of severe hemorrhoids with internal prolapse.Methods A total of 120 patients with severe hemorrhoids and internal prolapse who were treated in our hospital from January 2020 to January 2022 were selected as the research objects.They were divided into control group and observation group by random number table method,with 60 patients in each group.The control group was treated with procedure for prolapse and hemorrhoids,and the observation group was treated with suspension fixation on the basis of the control group.The short-term therapeutic effect,clinical operation index,pain score at 24 h after operation,first defecation pain score,anal function index(anal bulge and defecation score,anal resting pressure,anal maximum systolic pressure),complication rate and recurrence rate were compared between the two groups.Results The total effective rate of treatment in the observation group was 95.00%,which was higher than 80.00%in the control group(P<0.05).The operation time of the observation group was longer than that of the control group,the intraoperative blood loss was less than that of the control group,and the incision healing time and hospitalization time were shorter than those of the control group(P<0.05).The postoperative 24 h pain score,first defecation pain score,anal bulge and defecation score,anal resting pressure and anal maximum systolic pressure in the observation group were lower than those in the control group(P<0.05).The incidence of complications in the observation group was 6.67%,which was lower than 18.33%in the control group(P<0.05).After 6 months of follow-up,the recurrence rate of the observation group was 1.67%,which was lower than 11.67%of the control group(P<0.05).Conclusion The operation time of patients with severe hemorrhoids and internal prolapse treated with stapler hemorrhoidal mucosa circumcision combined with suspensio

关 键 词：吻合器痔上黏膜环切术 悬吊固定术 重度痔 脱垂 

分 类 号：R657.18[医药卫生—外科学]