悬吊绑缚动脉结扎切除闭合术治疗重度混合痔的临床研究

Clinical study on the treatment of severe mixed hemorrhoids by dearterialization rectopexy and closed hemorrhoidectomy

目的观察悬吊绑缚动脉结扎切除闭合术治疗重度混合痔的临床疗效。方法将160例重度混合痔患者随机分为治疗组与对照组,每组80例。对照组采用吻合器痔上黏膜环切钉合术联合外痔切除缝合治疗,治疗组采用悬吊绑缚动脉结扎切除闭合术治疗。观察比较两组手术时间、术中出血量、术后并发症(疼痛、尿潴留、出血)、肛门功能评分、住院时间、创面愈合时间、治疗费用情况。结果①最终完成试验者152例,其中治疗组74例、对照组78例。②治疗组术中出血量、住院费用少于对照组,差异有统计学意义(P<0.05)。③创面愈合时、术后6个月与手术前组内比较,两组肛门功能评分降低(P<0.05);组间各观察时间点比较,肛门功能评分差异无统计学意义(P>0.05)。④两组手术时间、术后并发症及处理情况、住院时间、创面愈合时间比较,差异无统计学意义(P>0.05)。结论悬吊绑缚动脉结扎切除闭合术治疗重度混合痔安全、有效、经济,且操作简便,值得临床推广应用。

Objective To investigate the clinical effect of dearterialization rectopexy and closed hemorrhoidectomy in the treatment of severe mixed hemorrhoids.Methods Randomly divide 160 patients with severe mixed hemorrhoids into treatment group and control group with 80 cases in each group.PPH with closed external hemorrhoidectomy were performed in the control group while dearterialization rectopexy and closed hemorrhoidectomy were used in the treatment group.The operative time,intraoperative blood loss,postoperative complications(pain,urinary retention,bleeding),continence score,length of stay,wound healing time and treatment cost were observed and compared in two groups.Results①A total of 152 patients completed the experiment,including 74 cases in the treatment group and 78 cases in the control group.②The amount of intraoperative bleeding and hospitalization cost in the treatment group were less than those in the control group and the difference was statistically significant(P<0.05).③At the time of wound healing and 6 months after operation,the continence score of the two groups both decreased compared to that of the two groups before operation(P<0.05);but there was no significant difference between the two groups at each observation time point(P>0.05).(4)There was no significant difference in operation time,postoperative complications and treatment,hospitalization time and wound healing time between the two groups(P>0.05).Conclusion It is safe,effective and economical to treat severe mixed hemorrhoids by dearterialization rectopexy and closed hemorrhoidectomy,and the operation is simple and convenient,which is worthy of clinical application.