吻合器痔上粘膜钉合术治疗重度痔技术改进

A Technique Modification of PPH for Severe Hemorrhoid

目的 探讨吻合器痔上粘膜钉合术 (procedureforprolapsehaemorrhoids,PPH)的技术改进 ,以减少并发症 ,提高疗效。 方法 将 87例行PPH术患者随机分为技术改进组 (A组 ) 4 6例和常规手术对照组 (B组 ) 4 1例。A组的技术改进主要包括双荷包缝合、缝合至粘膜下层、肛管外减压、消痔灵内痔注射等。观察手术时间、术后疼痛、住院时间、术后并发症及术后复发率。 结果 比较手术时间、术后疼痛、住院时间 ,两组无显著性差异 (P >0 .0 5 ) ;但A组肛门功能恢复时间短 ,术后并发症发生率低 ,复发率低 ,两组比较有显著性差异 (P <0 .0 5 )。 结论 通过对PPH进行技术改进 ,可以扩大其临床适应证 ,减少术后并发症 ,降低术后复发率 ,提高疗效。

Objective To evaluate the effect of a techni qu e modification of procedure for prolapsed hemorrhoids (PPH) for severe hemorrhoi d. Method 87 patients were randomly divided into two gro ups: group A underwent modified PPH and group B underwent unmodified PPH. The im provements mainly included double purse-string suture, suture into unica submuc osa, extra-anal decompression through anal tube and haemorrhoid injection. Oper ation time, hospital stay, post-operative pain, complication and recurrence wer e observed and compared. Result Comparing with group B, the complication rate and recurrent rate were significantly lower in group A ( P<0.05), while the operation time, post-operative pain and hospital stay show ed no significant difference between two groups (P>0.05). Conclu sions The modification of PPH can expand its clinical indications, r educe the complications and recurrent rates, and improve its effect.