吻合器痔上粘膜环切术并发症的预防及处理

The prevention and treatment of postoperative complications of procedure for prolapse and hemorrhoids

目的探讨吻合器痔上粘膜环切术（PPH）治疗重度痔术后并发症的发生原因及处理。方法回顾性总结分析我科2002年1月至2005年1月应用PPH治疗的106例重度痔患者的临床资料。结果本组106例，手术时间为10—35min，平均18．5min，术后平均住院时间3d。吻合部位在齿线上0．5—2cm。术中吻合后即刻出血46例，无术后早期出血病例，有3例（2．8％）患者发生迟发型出血。术后肛门部疼痛59例（55．7％），其中17例（16．0％）疼痛较重，需用药物止痛。31例（29．2％）术后出现急便感或肛门部异物感。轻度吻合口狭窄1例，术后6例残留皮赘，需局部修剪。术后随访过程中未出现复发病例。结论PPH具有疗效好、恢复快、疼痛少的优点。减少PPH并发症的关键是荷包缝合技术。

Objective To investigate the cause and treatmeat of postoperative complications of procedure for prolapse and hemorrhoids （PPH） in the treatment of severe hemorrhoids. Methods One hundred and six cases of severe hemorrhoids received PPH were analyzsed retrospectively. Results Mean operative time was 18.5 minutes and mean hospitalization was 3 days. Forty - six eases needed to suture hemostasis during operation. Delay bleeding were found in 3 cases after operation, anal pain in 59 cases, analgestic were necessary in 17 eases. ,Sensation of rectal unusual in 31 cases and anal incontinence in 1 case. Follow - up 6 ～ 30 months,the therapeutic effects were satisfactory. Conclusion PPH have many advantages, including safety, good effectiveness, rapid recovery and less pain after operation. For reducing postoperative complications it is important to take a right tech- nique of purse - string suture.