肛垫悬吊加外痔切除治疗环状混合痔的临床观察

Clinical Observation on Therapeutic Effect of Suspending Ano-cushion plus External Hemorrhoidectomy in the Treatment of Circumferential Mixed Hemorrhoids

为探讨减少混合痔术后并发症的手术治疗方法，将环状混合痔60例分为治疗组和对照组各30例。治疗组在齿状线上1～3cm区域做3次可吸收性埋线，纵向跨距缝扎，5～6针为一缝扎区，共3区，区间隔1cm，缝扎处注射少量1：1消痔灵液，外痔切口到齿状线平面结束，不损伤ATZ区，皮桥中段保留桥墩形的少许纤维。对照组采用外剥内扎术，内扎点交错在齿状线平面之上1～2cm，内痔区注射1：1消痔灵液，保留皮桥纵轴下少许纤维。与对照组相比，治疗组术后坠胀、排尿障碍、皮桥痔发生率都明显降低。

Sixty cases with circumferential mixed hemorrhoids were evenly divided into two groups. Thirty cases in the experiment group received the following surgical treatment： absorptable thread-burial treat ment 1-3cm above the dentate line（3 burial spots）;longitudinal spaced-out suture ＆ ligation,5-6 sticks per zone, totaled three zones, space being lcm;injection of Xiao Zhi Ling （1 ： 1）at the suture ＆ ligation area; incision of external hemorrhoids reaching the dentate line plane and keeping the ATZ region untouched; small amount of pier-shaped fibers preserved at the middle segment of the pedicle skin bridge. While the other 30 cases in the control group underwent ＂external dissection ＆ internal ligation＂, the locations of ＂internal ligation＂were 1-2cm above the dentate line plane,injecting Xiao Zhi Ling （1 ： 1） was done at the internal hemorrhoidal area, and small amount of fibers of the longitudinal pedicle skin bridge were reserved. As results, postoperative tenesmus, urinary dysfunction and the occurrence rate of pedicle skin bridge hemorrhoid were notably decreased.