吻合器痔上黏膜钉合术治疗重度混合痔的临床应用价值

Values of clinical application of stapled prolapsectomy(PPH) to the trea tment of severe mixed hemorrhoids.

目的探讨吻合器痔上黏膜钉合术(简称PPH)治疗重度混合痔的临床应用价值. 方法自2001年以来南方医科大学附属南方医院对128例重度混合痔病人分别进行PPH(或加外痔修剪)及外切内扎术,对两种术式疗效、手术时间、疼痛指数、住院时间、恢复工作时间、费用、并发症等进行全面的总结比较.结果经2～33个月随访,两组病人脱垂症状均消失,肛门缘无明显皮赘,效果满意.在手术时间、疼痛指数、住院时间、发生轻度肛门狭窄率方面,PPH组明显优于外切内扎组(P＜0.01).结论从避免并发症、减轻病人痛苦、提高病人生活质量方面来看,PPH是治疗重度混合痔尤其是内痔为主的环状痔病人的首选术式.

Objective To investigate the clinical value of PPH in the t reatment of severe mixed hemorrhoids.Methods One hundred and twenty-eight patients with severe mixe d hemorrhoids were treated by PPH and Milligan-Margan at Nanfang Hospital of th e South Medical University after 2001.The curative effect,operative time,pain in dex,length of hospitalization,time required for returning to normal activity,hos pital cost and complication of two groups were compared. Results There was no difference in prolapse symptom and anal n eoplasm between two groups.But compared with Milligan-Margan group,there were m ore advantages in operation time,hospital time,healing time,and occurrence rate of gently degree of anal stricture in PPH group(P<0.001).Conclusion PPH is the first choice for the treatment of severe mixed hemorrhoids,especially severe circumferential hemorrhoids to avoid the com plication,alleviate patient' s pain and improve life quality.