保留肛垫分瓣式缝吊内注术治疗环状混合痔的临床研究

Anal Pad Preserving Respective Resection of Internal and External Hemorrhoids for Treatment of Circumferential Mixed Hemorrhoids

目的 :探讨用新的手术方式治疗环状混合痔价值。方法 :以保留肛垫分瓣缝吊内注术治疗的病例为试验组 ,外剥内扎术治疗的病例为对照组。观察两个组的术后肛门解剖生理变化、术后并发症、术后恢复情况等指标。结果 :肛门解剖生理变化 :肛门周长试验组术前 (8.3± 0 .3) cm,术后 (8.1± 0 .4 ) cm,对照组术前 (8.4± 0 .3) cm,术后 (7.5± 0 .3) cm。术后肛管狭窄试验组0 ,对照组 14 .2 9% (4 / 2 8)。肛管弹性试验组手术前后无明显改变 ,对照组手术后明显变差。术后并发症 :术后疼痛、肛门水肿、大便失禁、肛门坠胀等发生率试验组明显低于对照组。创面愈合时间 :试验组 (13.6 1± 3.2 5 ) d,对照组 (2 0 .91± 3.82 ) d。结论 :保留肛垫分瓣缝吊内注术治疗环状混合痔能够保持肛门解剖生理结构 ,明显减少术后并发症 ,缩短创面愈合时间。

Objective:Using a new technique to improve the surgical result of circumferential mixed hemorrhoids.Methods:56 cases of circumferential mixed hemorrhoids were divided into two groups which treated respectively by anal pad-preserving(with intact dentate line)respective resection of the internal and external hemorrhoids(RR group) and those treated with routine approach of stripping off the varicose masses of the external hemorrhoids and ligating the internal(control group).Results:Perimeters of anus had no change in RR but shortened evidently in controls. Postoperative stricture of anus developed in none in RR and 4 cases in controls. Postoperative complications include postoperative anal pain, edema, incontinence and tenesmus were less in RR than in controls(P<0.05). Healing time of the operative wound was (13.61±3.25)days in RR and (20.91±3.82)days in controls.Conclusion:Compared with the routine approach in the treatment of circumferential mixed hemorrhoids, the new technique significantly retain better physiological functions of anus, and decreased postoperative complications, shortened the healing time of the operative wound.