经肛门镜下吻合器治疗重度痔360例

The Evaluation of Procedure for Prolapse and Hemorrhoid (PPH) for Severe Hemorrhoids

目的 :探讨经肛门镜下吻合器环形切除痔上黏膜 (ProcedureforProlapsandHemorrhoid ,PPH)治疗重度痔 (Ⅲ度、Ⅳ度痔 )的价值。方法 :回顾分析 36 0例重度痔经PPH术式的治疗资料。结果 :手术时间平均 1 3min ,术中即见痔块回缩塌陷 ,4 8例术中见结扎环出血 ,镜下经肛门直视缝合 1 2针后停止。 36例术后大便时滴少量鲜血持续 2 4d ,自行好转。术后平均住院 2 3d。术后随访 1 1 2个月 ,无反复血便及痔块脱垂 ;无肛门失禁、肛周感染及结扎环狭窄。结论 :PPH术式疗效确切且安全、住院时间短、不易复发和恢复快的优点 ,是治疗重度痔的一次革命 。

Objective:To evaluate the efficacy of Procedure for Prolapse and Hemorrhoid (PPH) for severe hemorrhoids(Ⅲ,Ⅳ degree hemorrhoids).Methods:Retrospectively analyzing 360 cases of severe hemorrhoids operated with PPH. Results:There were 312 cases of Ⅲ degree hemorrhoids and 48 cases of Ⅳ. The mean operation time was 13 minuts. Forty eight cases had bleeding at ligation,and hemostasia was successfully controlled by suture. There were 36 cases of dribbling blood when emptying the bowels for not more than 4 days, and had an automatic recovery. The mean time of hospitalization was 2 3 days. The follow up of 1~12 months showed that there was no repeating bloody stool, prolapse of hemorrhoids, incontinence, perianal infection and anal stenosis.Conclusion:PPH was great progress in treat serious hemorrhoids, and it was safe, effective, short time of hospitalization, less chance of relapse or complication and good recovery.