吻合器痔上黏膜环形切除术联合外剥内扎术治疗重度痔疮的效果  

Effect of Procedure for Prolapse and Hemorrhoidals Combined with Milligan-Morgan Haemorrhoidectomy in the Treatment of Severe Hemorrhoids

作　　者：林福气 邹孟瑶 刘忠传 LIN Fuqi;ZOU Mengyao;LIU Zhongchuan(Xiamen Chang Gung Hospital Affiliated to Huaqiao University,Xiamen 361000,China;不详)

机构地区：[1]华侨大学附属厦门长庚医院,福建厦门361000

出　　处：《中外医学研究》2024年第26期34-38,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究吻合器痔上黏膜环形切除术(PPH)联合外剥内扎术(M-M)治疗重度痔疮患者的效果。方法:回顾性收集2022年9月—2023年9月华侨大学附属厦门长庚医院收治的106例重度痔疮患者的病历资料,按手术方案不同分为试验组(接受PPH联合M-M治疗,n=53)与对照组(接受M-M治疗,n=53)。比较两组手术指标、肛肠动力学指标、疼痛评分、疼痛应激因子及并发症。结果:试验组术中失血量较对照组更少,创面愈合时间、手术用时、住院用时较对照组短,差异有统计学意义(P<0.05);术后1个月,两组肛管最大收缩压(MASP)、肛管静息压(ARP)较术前降低,且试验组较对照组低,差异有统计学意义(P<0.05);术后1 d,两组血清前列腺素E_(2)(PGE_(2))、5-羟色胺(5-HT)、P物质(SP)水平较术前升高,但试验组较对照组低,差异有统计学意义(P<0.05);试验组并发症发生率为1.89%(1/53),低于对照组的15.09%(8/53),差异有统计学意义(P<0.05)。结论:相较于单纯M-M,PPH联合M-M治疗重度痔疮患者可进一步优化手术指标,减轻疼痛感,改善肛肠动力学,降低并发症发生风险,且对机体疼痛应激因子水平影响更小。Objective:To investigate the effect of procedure for prolapse and hemorrhoidals(PPH)combined with Milligan-Morgan(M-M)haemorrhoidectomy in the treatment of severe hemorrhoids.Method:The medical records of 106 patients with severe hemorrhoids who admitted to Xiamen Chang Gung Hospital Affiliated to Huaqiao University from September 2022 to September 2023 were retrospectively collected,they were divided into the experimental group(receiving PPH combined with M-M treatment,n=53)and the control group(receiving M-M treatment,n=53)according to different surgical procedures.The surgical indexes,anorectal dynamics indexes,pain scores,pain stress factors and complications were compared between two groups.Result:The intraoperative blood loss in the experimental group was less than that in the control group,and the wound healing time,operation time and hospitalization time were shorter than those in the control group,and the differences were statistically significant(P<0.05);at 1 month after operation,the maximum anal systolic pressure(MASP)and anal resting pressure(ARP)of two groups were lower than those before operation,and those in the experimental group were lower than those in the control group,the differences were statistically significant(P<0.05);at 1 d after operation,the levels of serum prostaglandin E_(2)(PGE_(2)),5-hydroxytryptamine(5-HT)and substance P(SP)in two groups were higher than those before operation,but those in the experimental group were lower than those in the control group,the differences were statistically significant(P<0.05);the incidence of complications in the experimental group was 1.89%(1/53),which was lower than 15.09%(8/53)in the control group,and the difference was statistically significant(P<0.05).Conclusion:Compared with M-M alone,PPH combined with M-M in the treatment of severe hemorrhoids can further optimize surgical indexes,alleviate pain,improve anorectal dynamics,reduce the risk of complications,and have less impact on the level of pain stress factors.

关 键 词：吻合器痔上黏膜环形切除术 肛肠动力学 痔疮 

分 类 号：R657.18[医药卫生—外科学]