混合痔内注套扎外痔剥缝防治术后出血的临床观察

Clinical Observation of a Combination Surgery Treatment of Internal Injection,Ligation and Dissection ＆ Suture for External Hemorrhoids in Prevention ＆ Treatment of Postoperative Bleeding of Mixed Hemorrhoids Patients

为了探讨对混合痔患者采用内痔痔上动脉区及窦状静脉区注射消痔灵，自动套扎器套扎，外痔剥除缝合术式防治术后出血的疗效，将201例混合痔患者分为治疗组99例和对照组102例。治疗组采用混合痔内痔痔上动脉区及窦状静脉区注射消痔灵稀释液后，用自动套扎器套扎，再行外痔剥除缝合术式。对照组采用混合痔内痔套扎后注射消痔灵稀释液外痔剥除缝合，观察两组的术后出血率及治愈率。结果显示，治疗组术后1d、7d、14d出血率均明显少于对照组，差异有统计学意义（P〈0．05），两组治愈率差异无统计学意义（P〉0．05）。结果表明，两种手术方式均可以有效治疗混合痔，而治疗组的术式能够明显降低术后出血量，消除痔核、肛垫复位较完整，肛肠顺应性好，括约肌功能完好。

This study was to explore the effect of preventing ＆ treating mixed hemorrhoids patient＇s post-operative bleeding by using a combination surgical treatment,i.e in the superhemorrhoidal arteries area and sinusoidal venus area injecting Xiaozhiling injection, performing ligation with Ruiyun Procedure, and dissection ＆ suture on external hemorrhoids,divided 201 cases of mixed hemorrhoids into treatment group （ n = 99） and control one （ n = 102） ; performed above combination treatment （the order as above-mentioned） on treatment group, meanwhile performed the order of following procedures, as first ligation of internal hemorrhoids,then injecting diluted Xiaozhiling injection,followed by dissection ＆ suture of external hemorrhoids,on control group; then observed both group＇s incidence of postoperative bleeding, and curative rate.As results,in treatment group the bleeding incidence at 1,7,14 days after operation was significantly less than that in control group（ P〈0.05）,there was statistically significance in the curative rate of both groups there was no statistical difference（ P〉0.05）.Results show that above two procedures can all treat mixed hemorrhoids effectively, but the procedure received by treatment group can more significantly reduce the bleeding volume, strip hemorrhoids mass off, elevate anal cushion and more completely, and so that anoreetum has a good compliance and sphincter function is good.