吻合器痔上黏膜环切手术对环状混合痔患者术后疼痛、肛肠功能的影响及安全性分析  

Analysis the Effect and Safety of Procedure for Prolapse and Hemorrhoids on Postoperative Pain and Anorectal Function in Patients with Circumfer⁃ential Mixed Hemorrhoids

作　　者：方松山 FANG Songshan(Department of Proctology,Third Hospital of Zhangzhou City,Zhangzhou,Fujian,363000,China)

机构地区：[1]漳州市第三医院肛肠科,福建漳州363000

出　　处：《中外医疗》2024年第34期45-48,共4页China & Foreign Medical Treatment

摘　　要：目的探讨环状混合痔患者采用吻合器痔上黏膜环切手术(procedure for prolapse and hemorrhoids,PPH)对术后疼痛、肛肠功能的影响及安全性分析。方法随机选取2022年2月—2024年2月漳州市第三医院收治的300例环状混合痔患者作为研究对象,根据不同手术方法分为对照组(n=150)和研究组(n=150),对照组采用传统外剥内扎术(milligan-morgan haemorrhoids,MMH),研究组采用PPH手术,比较两组围手术期指标、术后疼痛情况、肛肠功能、并发症发生情况。结果研究组手术时间、创口愈合时间、首次排便时间和住院时间均短于对照组,术中出血量均少于对照组,差异均有统计学意义(P均<0.05)。术后12 h、24 h,研究组视觉模拟评分法评分均低于对照组,差异均有统计学意义(P均<0.05)。术后3个月,研究组肛管静息压、肛管最大收缩压均高于对照组,肛管高压带长度长于对照组,Wexner便秘评分低于对照组,差异均有统计学意义(P均<0.05)。研究组并发症总发生率为7.33%(11/150),低于对照组的18.67%(28/150),差异有统计学意义(χ^(2)=8.518,P<0.05)。结论PPH手术应用于环状混合痔患者中,可缩短手术时间及伤口愈合时间、降低术中出血量,缓解术后疼痛感,有利于肛肠功能恢复,降低并发症发生率。Objective To investigate the effect and safety of procedure for prolapse and hemorrhoids(PPH)on postop-erative pain and anorectal function in patients with circumferential mixed hemorrhoids.Methods A total of 300 pa-tients with circumferential mixed hemorrhoids admitted to the Third Hospital of Zhangzhou City from February 2022 to February 2024 were randomly selected as the research objects.According to different surgical methods,they were divided into control group(n=150)and study group(n=150).The control group was treated with traditional milligan-morgan haemorrhoids(MMH),and the study group was treated with PPH.The perioperative indicators,postoperative pain,anorectal function and complications were compared between the two groups.Results The operation time,wound healing time,first defecation time and hospitalization time of the study group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group,the differences were statistically signifi-cant(all P<0.05).At 12 h and 24 h after operation,the Visual Analogue Scale score of the study group was lower than that of the control group,and the differences were statistically significant(both P<0.05).At 3 months after operation,the anal resting pressure and anal maximum systolic pressure in the study group were higher than those in the control group,the length of anal high pressure band was longer,and the Wexner Constipation Score was lower than that in the control group,the differences were statistically significant(all P<0.05).The total incidence of complications in the study group was 7.33%(11/150),which was lower than 18.67%(28/150)in the control group,and the difference was statistically significant(χ^(2)=8.518,P<0.05).Conclusion The application of PPH surgery in patients with circular mixed hemorrhoids can shorten the surgical time and wound healing time,reduce intraoperative bleeding,alleviate postoperative pain,promote the recovery of anal and intestinal function,and reduce the incidence of complicat

关 键 词：吻合器痔上黏膜环切手术 环状混合痔 疼痛 肛肠功能 安全性 

分 类 号：R266[医药卫生—中医外科学]