吻合器痔切除和常规痔切除术后肛门温度觉的比较  

Comparison of influence on the anal temperature sensation by PPH and conventional hemorrhoidectomy

作　　者：姚航[1] 傅传刚[1] 金黑鹰[1] 刘连杰[1] 王汉涛[1] 张卫[1] 徐洪莲[1] 

机构地区：[1]第二军医大学附属长海医院肛肠外科,上海200433

出　　处：《中国实用外科杂志》2003年第8期492-494,共3页Chinese Journal of Practical Surgery

摘　　要：目的　比较吻合器痔切除术和常规痔切除术后肛门温度觉的差异。方法　利用自制的肛门温度觉测量仪测量经肛门镜下吻合器痔切除术 (PPH)和常规痔切除手术前后肛门可感觉的最小温度变化值 (minimumde tectabletemperaturechange ,MDTC)的变化。术前、术后肛门镜检查痔核大小及出血情况。切除标本病理检查。结果　PPH手术后 10例病人痔核明显缩小 ,出血停止。病理检查标本中未见有肌肉组织及痔组织。肛管的MDTC值均较术前降低 ,肛管下部和中部MDTC值下降明显 (P <0 0 5 ) ,肛管上部最显著 (P <0 0 1)。常规痔切除手术后 10例病人的MDTC值均较术前增高 ,肛管上部、中部和下部MDTC值均升高明显。痔核消失 ,出血停止。病理检查标本中无肌肉组织 ,但有痔组织。结论　PPH手术可保护肛垫 ,使痔病人术后肛门感觉改善 ,控便功能加强。Objective To compare the influence of PPH with that of conventional hemorrhoidectomy on the anal temperature sensation. Methods The anal minimum detectable temperature change (MDTC) was measured by a self-made instrument which can detect temperature before and after PPH or conventional hemorrhoidectomy.The hemorrhoidal node size and hemorrhage were inspected by anoscopy.The resected specimen was examined histologically.Results After PPH operation,MDTC values in all the ten patients decreased.There was a slight but significant decrease in the lower and middle zones of the anal canal ( P <0.05),and a more marked decrease in the upper zone ( P <0.01).The hemorrhoidal node size of the ten patients was reduced after PPH and the bleeding stopped.The histological examination showed that there was no muscle and hemorrhoids tissue in the specimen.After conventional hemorrhoidectomy,all patients’MDTC values increased.There was an increase in the lower,middle and high zones of the anal canal ( P <0.05).The ten patients’hemorrhoidal nodes disappeared after conventional hemorrhoidectomy and the bleeding stopped.The histological examination found hemorrhoids tissue,but no muscle.Conclusion PPH can protect anal cushion and improve the anal sensation and continence function.

关 键 词：吻合器 痔切除 常规痔切除术 肛门温度觉 比较 

分 类 号：R657.18[医药卫生—外科学]