吻合器痔上黏膜钉合术并发症的原因及对策

Reasons and countermeasure of complications after procedure for prolapse and haemorrhoids

目的探讨吻合器痔上黏膜钉合术(PPH)术后并发症的原因和对策。方法2000年7月至2004年10月对504例Ⅲ、Ⅳ度内痔病人行PPH术,分析术后发生并发症的原因及对策。结果504例病人的平均手术时间为9min;术后1d疼痛的发生率为20.5%,出血发生率为5.7%;1个月以后(5～12周)再出血率为10.9%(55/504)。3例出现吻合口狭窄,分别发生在术后1、3和9个月。平均随访时间为(42.4±6.6)个月,随访率为91.4%(455/498),2例严重的内痔病人作了再次PPH术,其余病人均无复发。结论只要能正确处理并发症,PPH具有手术时间短、创伤小、恢复快、并发症少等优点,是治疗重度内痔的理想方法。

Objective To assess the reasons and countermeasure of the complications after procedure for prolapse and haemorrhoids （PPH）. Methods Five hundreds and four cases of Ⅲ-and Ⅳ-degree haemorrhoids were treated with PPH from July 2000 to October 20（0. The reasons and countermeasure of the complications were analyzed. Results Of the 504 patients,the mean operation time was 9 min. in the next day after procedures, pain rate was 20. 5% and the bleeding rate was 5.7%. 10. 9% （55/504） of patients had re-bleeding 7w （5 - 12w） after procedures. Only 3 patients were found stricture in the rectum 1,3 and 9 months after the procedure. In 455 followed-up patients （455/498,91.4%） ,there were only 2 severe patients had twice of procedure and no recurrence in other patients. Conclusion PPH is effective, safe, minimal invasive method and is the ideal choice to treat severe haemorrhoids.