自动痔疮套扎术与外剥内扎术治疗Ⅲ、Ⅳ期混合痔的对照研究

A controlled research of automatically hemorrhoids ligation and Milligan-Morgan hemorrhoidectomy in treatment of patients with Ⅲ or Ⅳ degree mixed hemorrhoids

目的探讨自动痔疮套扎术(RPH)和外剥内扎术(M-M)治疗Ⅲ、Ⅳ期混合痔的临床效果。方法将达州市中心医院2013年1月—2014年12月间收治的164例Ⅲ、Ⅳ期混合痔患者随机分观察组和对照组,每组82例。患者麻醉后,对照组给予外剥内扎术(M-M)治疗,观察者给予自动痔疮套扎术(RPH)治疗。治疗后,对2组创面愈合时间、临床治疗效果、并发症(肛缘水肿、出血、皮赘形成、排尿障碍、疼痛)等进行观察,并使用统计学软件进行分析。结果观察组创面愈合时间为(21.5±4.9)d,显著低于对照组的(25.1±6.2)d,差异有统计学意义(P<0.05)。观察组总有效率为95.1%,显著高于对照组的84.1%,差异有统计学意义(P<0.05)。观察组肛缘水肿、出血、排尿障碍、疼痛评分和皮赘形成病例分别为(2.2±0.7)分、(3.6±0.9)分、(2.1±0.6)分、(3.1±0.8)分和8例,均显著低于对照组的(2.9±0.8)分、(4.1±1.1)分、(2.7±08)分、(3.9±0.9)分和20例,差异有统计学意义(P<0.05)。结论相比于传统外剥内扎术,自动痔疮套扎术治疗Ⅲ、Ⅳ期混合痔具有效果满意、创面愈合时间短、有效率高、并发症率低的优势。

Objective To investigate the clinical effect of automatic hemorrhoids ligation（ RPH,modified rubber band ligation） and Milligan-Morgan Hemorrhoidectomy（ M-M） in treatment of patients with Ⅲ or Ⅳ degree mixed hemorrhoids. Methods Total 164 cases of Ⅲ or Ⅳ degree Mixed hemorrhoids in our hospital from January 2013 to December2014 were randomly divided into observation group and control group,with 82 cases in each group. The patients in the control group were given Milligan-Morgan Hemorrhoidectomy（ M-M）,while the patients in the observation group were given automatically hemorrhoids ligation（ RPH）. The wound healing time,clinical efficacy and complications（ anal margin edema,bleeding,skin tag forming,dysuria,and pain） of both groups were observed. Results The wound healing time of the observation group was（ 21. 5 ± 4. 9） d,which was significantly shorter than that in the control group[（ 25. 1 ± 6. 2）d],P〈0. 05. The total effective rate of the observation group was 95. 1%,which was significantly higher than that in the control group 84. 1%（ P〈0. 05）. The anal margin edema,bleeding,skin tag forming,dysuria,and pain status of the observation group were 2. 2 ± 0. 7,3. 6 ± 0. 9,2. 1 ± 0. 6,3. 1 ± 0. 8,8 cases,respectively,which were significantly better than control group（ 2. 9 ± 0. 8,4. 1 ± 1. 1,2. 7 ± 0. 8,3. 9 ± 0. 9,and 20 cases,respectively）,P〈0. 05. Conclusion Compared with traditional Milligan-Morgan Hemorrhoidectomy,automatic hemorrhoid ligation can effectively treat Ⅲ or Ⅳdegree mixed hemorrhoids,with advantage of short wound healing time,high efficacy and low complication.