RPH联合外痔切除术治疗Ⅲ～Ⅳ期混合痔的临床分析

Clinical analysis of RPH combined with external hemorrhoidectomy for stage Ⅲ-Ⅳ hemorrhoids

目的:探讨自动痔疮套扎术(Ruiyun procedure for hemorrhoids,RPH)联合外痔切除术治疗Ⅲ～Ⅳ期混合痔患者的临床疗效及术后并发症的发生情况,为临床广泛开展应用提供客观依据。方法:选择2016-03-01～2018-03-01某院肛肠外科收治的145例Ⅲ～Ⅳ期混合痔患者为研究对象,随机分为研究组(采用RPH联合外痔切除手术,n=75)和对照组(采用传统的外剥内扎手术,n=70),观察两组的手术总体疗效、手术时间、创面愈合时间、术后疼痛程度及术后并发症发生情况(如出血、尿潴留、肛缘水肿、肛门狭窄或失禁),评价RPH微创治疗痔疮的优越性。结果:研究组手术总体疗效与对照组相比差异无统计学意义(P>0.05),但研究组手术时间、创面愈合时间、术后疼痛程度及术后并发症发生情况与对照组相比,差异有统计学意义(P<0.05)。结论:RPH联合外痔切除术治疗Ⅲ～Ⅳ期混合痔手术时间短、创面愈合快、术后疼痛轻、术后并发症少,具有更加微创的效果,值得临床推广应用。

Objective:To evaluate the clinical efficacy and postoperative complications of Ruiyun procedure for hemorrhoids(RPH)combined with external hemorrhoidectomy in the treatment of stage Ⅲ-Ⅳ mixed hemorrhoids,and to provide an objective basis for clinical application.Methods:A total of 145 patients with stageⅢ-Ⅳ mixed hemorrhoids admitted to the anorectal surgery from March 1 2016 to March 1 2018 were selected and randomly divided into the study group(RPH combined with external hemorrhoidectomy,75cases)and the control group(traditional external stripping and internal ligation,70cases).The overall efficacy of the two surgical methods,operation time,wound healing time,postoperative pain degree,and postoperative complications(such as bleeding,urinary retention,anal edema,anal stenosis or incontinence) were observed,the superiority of RPH minimally invasive treatment of hemorrhoids was compared.Results:There was no significant difference between the study group and the control group in overall efficacy(P>0.05),but there were significant differences in the operation time,wound healing time,postoperative pain degree and postoperative complications(P <0.05).Conclusion:RPH combined with external hemorrhoidectomy in the treatment of stage Ⅲ-Ⅳ hemorrhoids has short operation time,rapid wound healing,light postoperative pain,less postoperative complications,and more minimally invasive effect,which is worthy of clinical application.