“降落伞”缝合法用于痔上黏膜环切术价值的探讨

To explore the value of parachute suture in pph

目的对比降落伞缝合法与双荷包缝合法用于吻合器痔上黏膜环切手术(procedure for prolapse and hemorrhoides,PPH)治疗Ⅲ、Ⅳ内痔的效果及术后并发症的情况。方法通过回顾2013年1月至2018年9月期间,在江门市中心医院江海分院普外科诊断为Ⅲ、Ⅳ度内痔或混合痔,并接受了PPH手术的患者95例,采用双荷包缝合法53例,降落伞法42例,比较两组患者切除直肠黏膜的情况及术后随访情况。结果双荷包组切除的直肠黏膜厚度明显厚于降落伞组;而降落伞组切除的黏膜宽度及完整性则显著优于双荷包组(P<0.01);在术后情况的比较中,双荷包组术后疼痛的程度显著高于降落伞组,术后恢复时间也长于降落伞组。结论降落伞缝合法联合黏膜悬吊用于Ⅲ、Ⅳ度内痔的治疗,能增加切除直肠黏膜的长度及均匀性,能降低术后疼痛的发生率,具有一定临床价值。

Objective To compare the effect of parachute suture and double-purse suture in PPH forinternal hemorrhoids III and IV and the complications after operation. Methods From January 2013to September 2018, 95 patients with grade Ⅲ and Ⅳ internal hemorrhoids or mixed hemorrhoids whounderwent PPH were reviewed. 53 patients underwent double-purse suture and 42 patients underwentparachute suture. The rectal mucosa excision and follow-up were compared between the two groups.Results The thickness of rectal mucosa resected in the double-purse group was signifi cantly thicker thanthat in the parachute group, while the width and integrity of the resected mucosa in the parachute groupwere signifi cantly better than that in the double-purse group (P<0.01). In the comparison of the postoperativeconditions, the degree of pain in the double-purse group was significantly higher than that in theparachute group, and the recovery time was also longer than that in the parachute group. ConclusionParachute suture combined with mucosal suspension can increase the length and uniformity of resectedrectal mucosa, reduce the incidence of postoperative pain, and has a certain clinical value in the treatmentof grade Ⅲ and Ⅳ internal hemorrhoids.