PPH联合小“V”切口外痔剥除术治疗重度混合痔的效果及价值体会

Effect and Value of PPH Combined with Small "V" Incision Hemorrhoidectomy in the Treatment of Severe Mixed Hemorrhoids

目的探析重度混合痔患者联合采用PPH(吻合器痔环切术)和小"V"切口外痔剥除术治疗的临床价值。方法于2017年10月—2019年1月天津市蓟州区人民医院收治的重度混合痔患者中选取112例,遵从随机数字表法分成参照组和干预组,参照组患者(n=56)采用PPH手术,干预组患者(n=56)在PPH手术治疗的前提下加用小"V"切口外痔剥除术。比较两组治疗效果、手术指标、术后疼痛程度、并发症发生率。结果(1)干预组总疗效较参照组高,差异有统计学意义(P<0.05);(2)干预组各项手术指标均优于参照组,差异有统计学意义(P<0.05);(3)干预组术后3 d及1周疼痛评分均低于参照组,差异有统计学意义(P<0.05);(4)参照组并发症总发生率高于干预组,差异有统计学意义(P<0.05)。结论小"V"切口外痔剥除术结合PPH治疗重度混合痔效果可靠,能减轻疼痛,优化手术指标,降低并发症发生几率,临床推荐价值高。

Objective To explore the clinical value of PPH(stapler hemorrhoidectomy)combined with small"V"incision hemorrhoidectomy in patients with severe mixed hemorrhoids.Methods From October 2017 to January 2019,112 patients with severe mixed hemorrhoids in the hospital were selected and divided into the reference group and the intervention group according to the random number table.The reference group(n=56)was treated with PPH,and the intervention group(n=56)was treated with small"V"incision hemorrhoidectomy on the premise of PPH.The therapeutic effect,operative index,degree of pain and incidence of complications were compared between the two groups.Results(1)The total curative effect of the intervention group was higher than that of the reference group,with statistically significant difference(P<0.05);(2)the operation indexes of the intervention group were better than those of the reference group,with statistical difference(P<0.05);(3)the pain score of the intervention group was lower than that of the reference group in three days and one week after operation,with significant difference(P<0.05);(4)the total incidence of complications of the reference group was higher than that of the intervention group,with statistical difference(P<0.05).Conclusion Small"V"incision hemorrhoidectomy combined with PPH in the treatment of severe mixed hemorrhoids is reliable,can reduce pain,optimize surgical indicators,reduce the incidence of complications,clinical recommendation value is high.