吻合器选择切闭加硬注术与外剥内扎硬注术治疗Ⅲ～Ⅳ度痔对比研究

The Clinic Effect of Selective Excision with Stapler, Sclerotherapy and External Excision and Internal Ligation for Ⅲ～Ⅳ Degree Hemorrhoid

目的:对吻合器选择切闭加硬注术治疗Ⅲ～Ⅳ度痔的手术疗效评价.方法:采用多中心随机单盲法分为观察组吻合器选择切闭加硬注术治疗60例和对照组外剥内扎硬注术治疗60例对比观察.观察其有效例数、住院时间、恢复工作时间、疗程、术后并发症等指标.结果:观察组60例中痊愈21例,显效26例,有效11例,无效2例;平均住院时间(4.4±0.74)d;平均恢复工作时间(6.32±1.03)d;平均疗程(9.55±1.44)d;术后并发症(出血、尿潴留、肛缘水肿)19例.对照组60例中痊愈19例,显效22例,有效13例,无效6例;平均住院时间(7.28±1.51)d;平均恢复工作时间(10.97±1.55)d;平均疗程(16.15±1.86)d;术后并发症(出血、尿潴留、肛缘水肿)31例.两组比较,观察组明显优于对照组(P<0.01).结论:吻合器选择切闭加硬注术治疗Ⅲ～Ⅳ度痔是一种有效方法.

Objective：To evaluate the role of selective excision with stapler, sclerotherapy and external excision and internal ligation in the treatment of Ⅲ～Ⅳ degree hemorrhoid. Methods： 120 patients with Ⅲ～Ⅳ degree hemorrhoid were divided into two groups with randomized and single-blind method. 60 cases were treated with selective excision with stapler and sclerotherapy and 60 cases with external excision and internal ligation and sclerotherapy. Results：No difference in the curative rate was found between the two groups （ P 〉0. 05 ）. The average hospital stay, the mean time of returning to work, the mean time of therapy, postoperative wound pain score in former group were obviously better than that in the other group （ P 〈0. 01）. Conclusion：selective excision with stapler and sclerotherapy was an effective method for Ⅲ～Ⅳ degree hemorrhoid. The procedure was simple and safe with short length of hospital stay and few complications.