吻合器痔上黏膜环切术与外剥内扎术对重度痔疮患者术后创面愈合、疼痛程度及复发率的影响观察  

Effects of procedure for prolapse and hemorrhoids and Milligan-Morgan on postoperative wound healing,pain degree and recurrence rate in patients with severe hemorrhoids

作　　者：苏宁亚 白雪峰 张俊杰 张晓娜 Su Ning-ya;Bai Xue-feng;Zhang Jun-jie;Zhang Xiao-na(Department of General Surgery,The 990 Hospital of PLA,Zhumadian 463000,Henan,China)

机构地区：[1]联勤保障部队第九九〇医院普外科,河南驻马店463000

出　　处：《四川生理科学杂志》2024年第12期2782-2784,共3页

摘　　要：目的:探讨吻合器痔上黏膜环切术(PPH)与外剥内扎术对重度痔疮患者术后创面愈合、疼痛程度及复发率的影响。方法:选取2020年06月-2023年06月在本院确诊的80例重度痔疮患者,采用简单随机分组将患者分为PPH组(n=40,行PPH术)和传统组(n=40,给予外剥内扎术)。比较两组患者手术时间、创面愈合时间等手术指标、术后不同时间点的疼痛程度,记录两组并发症发生情况。随访1 y,对比PPH组和传统组患者复发情况。结果:PPH组手术时间、术中出血量、创面愈合时间、住院时间等手术指标均低于传统组(P<0.05);术后24 h、首次排便及术后7 d,PPH组患者疼痛评分低于传统组(P<0.05);术后3 m PPH组总并发症发生率为12.50%,与传统组的27.50%对比无明显差异(P>0.05)。随访1 y,PPH组共复发1例,复发率为2.50%;传统组共复发8例,复发率为20.00%,PPH组低于传统组(P<0.05)。结论:与外剥内扎术相比,PPH能缩短患者手术时间、住院时间,减少出血量,有利于创面愈合,术后疼痛程度更轻,术后并发症更少,且复发率低。Objective:To explore the effects of procedure for prolapse and hemorrhoids(PPH)and Milligan-Morgan on postoperative wound healing,pain degree and recurrence rate in patients with severe hemorrhoids.Methods:A total of 80 patients with severe hemorrhoids confirmed in the hospital were enrolled between June 2020 and June 2023.According to simple random grouping method,they were divided into PPH group(n=40,PPH)and traditional group(n=40,Milligan-Morgan).The surgical indexes(operation time,wound healing time),pain degree at different time points after surgery were compared between the two groups.The occurrence of complications in the two groups was recorded at 3 months after surgery.All patients were followed up for 1 year to compare recurrence between PPH group and traditional group.Results:The operation time,intraoperative blood loss,wound healing time and length of hospital stay in PPH group were lower than those in traditional group(P<0.05).At 24 hours after surgery,after the first defecation and at 7 days after surgery,pain scores in PPH group were lower than those in traditional group(P<0.05).After 3 months after surgery,there was no significant difference in total incidence of complications between PPH group and traditional group(12.50%vs 27.50%,P>0.05).After 1 year of follow-up,there was 1 case(2.50%)with recurrence in PPH group and 8 cases(20.00%)with recurrence in traditional group,and recurrence rate in PPH group was lower than that in traditional group(P<0.05).Conclusion:Compared with Milligan-Morgan,PPH can shorten operation time and length of hospital stay,reduce blood loss,which is conducive to wound healing,with milder postoperative pain,fewer postoperative complications and lower recurrence rate.

关 键 词：重度痔疮 吻合器痔上黏膜环切术 外剥内扎术 愈合 疼痛 复发 

分 类 号：R657.18[医药卫生—外科学]