不同手术方法在老年重度混合痔患者治疗中的效果观察  

Observation on the effect of different surgical methods in the treatment of senile patients with severe mixed hemorrhoids

作　　者：周朝 隋守森 郑中伟 Zhou Chao;Sui Shou-sen;Zheng Zhong-wei(Department of Surgery,Shangqiu Renhe Hospital of Traditional Chinese Medicine,Shangqiu 476000,Henan China)

机构地区：[1]商丘仁和中医院外科,河南商丘476000

出　　处：《四川生理科学杂志》2024年第5期1071-1073,共3页Sichuan Journal of Physiological Sciences

摘　　要：目的:对比痔上黏膜环切术与痔结扎术治疗老年重度混合痔的临床效果。方法:回顾性选取2021年7月至2023年4月期间我院收治的84例老年重度混合痔患者作为研究对象。按照不同手术方法为结扎组和环切组,每组各42例。对照组行痔结扎术,观察组行痔上黏膜环切术。比较两组的围术期指标、术后1 w内肛门动力学(肛管舒张压、肛管静息压、最大收缩压)水平、肛门括约肌功能、疼痛程度及并发症状况。结果:与干预前相比,各治疗组疼痛程度和肛门括约肌功能评分、手术时间、住院时间、创面愈合时间、术中出血量均明显下降(P<0.05),其中环切组更为显著(P<0.05);与干预前相比,各治疗组最大收缩压、肛管舒张压、肛管静息压均显著升高(P<0.05),其中环切组更显著(P<0.05);两组的并发症发生率相比差异无统计学意义(P>0.05)。结论:痔上黏膜环切术治疗老年重度混合痔,能缩短手术时间、减少术中出血量,减轻术后疼痛感,促进肛门功能、肛门括约肌功能恢复,安全可靠。Objective:To compare the clinical effects of hemorrhoidal mucosa circumferential resection and hemorrhoidal ligation in the treatment of severe mixed hemorrhoids in the elderly.Methods:84 elderly patients with severe mixed hemorrhoids admitted to our hospital from July 2021 to April 2023 were retrospectively selected as the study objects.There were 42 cases in each group,ligation group and circumferential group according to different surgical methods.The control group underwent hemorrhoidal ligation,and the observation group underwent circumferential hemorrhoidal mucosa.Perioperative indexes,anal dynamics(anal diastolic pressure,anal resting pressure,maximum systolic pressure),anal sphincter function,pain degree and complications were compared between the two groups.Results:Compared with before intervention,the pain degree,anal sphincter function score,operation time,hospital stay,wound healing time and intraoperative blood loss in all treatment groups were significantly decreased(P<0.05),especially in the circumferential group(P<0.05).Compared with before intervention,the maximum systolic pressure,diastolic pressure of anal canal and resting pressure of anal canal in all treatment groups were significantly increased(P<0.05),especially in the circumferential group(P<0.05).There was no significant difference in complication rate between the two groups(P>0.05).Conclusion:Hemorrhoidal mucosa circumferential surgery in the treatment of severe mixed hemorrhoids in the elderly can shorten the operation time,reduce the amount of blood loss,relieve postoperative pain,promote the recovery of anal function and anal sphincter function,and is safe and reliable.

关 键 词：重度混合痔 痔结扎术 痔上黏膜环切术 围术期指标 

分 类 号：R473.6[医药卫生—护理学]