吻合器痔上黏膜环形切除术治疗重度痔疮的3年疗效评价  

Evaluation of the procedure for prolapse and hemorrhoids:three years'experiences

作　　者：姚礼庆[1] 钟芸诗[1] 孙益红[1] 戈少云[1] 刘厚宝[1] 郑烈伟[1] 

机构地区：[1]复旦大学附属中山医院普通外科,上海200032

出　　处：《中华胃肠外科杂志》2004年第2期120-123,共4页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨吻合器痔上黏膜环形切除术(PPH)治疗重度痔疮的临床疗效。方法对2000年7月至2003年7月我院收治的352例Ⅲ、Ⅳ度痔疮患者行PPH术,比较患者术前和术后1、6、30d以及随访终点时的疼痛、出血、坠胀和水肿情况。结果352例患者的平均手术时间为9min;术后1d疼痛的发生率为20.5%、出血的发生率为5.7%;至术后30d时疼痛、出血情况明显改善。术后(46.9±10.9)h首次排便;平均住院(4.4±1.2)d;恢复正常工作的平均时间为(8.0±1.7)d。术后并发症以尿潴留(10.0%)和出血(5.7%)多见。随访313例患者(93.6%),平均随访时间(27.0±7.4)个月,仅有4.5%的患者表现为少量出血,其余均恢复良好,无复发。结论吻合器痔上黏膜环形切除术具有手术时间短、创伤小、恢复快、并发症少等优点,是治疗重度内痔的理想方法。Objective To assess the clinical value of procedure for prolapse and hemorrhoids(PPH). Methods Three hundred and fifty two patients with Ⅲ°and Ⅳ°hemorrhoids underwent PPH from July 2000 to July 2003. Pain,bleeding,prolapse and edema in anus before the procedure,1 day,6 days and 30 days after the procedure, and at the end of the follow up were compared. Results Of the 352 patients, the mean operative time was 9 min. On the first day after the procedure, pain occurred in 20.5%of the cases and bleeding in 5.7%, but 30 days later, both pain and bleeding were relieved. All the patients passed the first tool after (46.9±10.9)h postoperatively. The mean hospital stay was (4.4±1.2)d. Most of the patients resumed work after (8.0±1.7)d postoperatively. Retention of urine(10%) and bleeding(5.7%) were the main complications and other unusual complications included infection,stricture and back pain. After a mean follow up time of (27.0±7.4) months, only 4.5%of the cases had a little bleeding and most recovered well with no recurrence. Conclusion PPH is effective, safe, minimally invasive, and is the first choice to deal with severe hemorrhoids.

关 键 词：吻合器痔上黏膜环形切除术 外科治疗 重度痔疮 手术方法 

分 类 号：R657.1[医药卫生—外科学]