吻合器痔上黏膜环形切除术结合血栓取出术治疗急性嵌顿性环状混合痔

Combined procedure for prolapse hemorrhoids with embolectomy surgery for acute incarceration of circumferential mixed hemorrhoids

目的:探讨吻合器痔上黏膜环形切除术结合血栓取出术治疗急性嵌顿性环状混合痔的可行性及临床价值。方法:对本院2004年1月-2005年8月收治的38例急性嵌顿性环状混合痔采用吻合器痔上黏膜环形切除术结合血栓取出术治疗,对术后疗效及并发症进行随访研究。结果:平均住院时间4 d,平均手术时间17.4 m in。术后76.3%痔核完全回缩,水肿消退。术后当日23.7%肛门疼痛需止痛处理。术后并发症的发生以下腹部酸胀不适(71.1%)、尿潴留(15.8%)发生多见。平均随访21.3周,无1例复发,无肛门狭窄、大便失禁发生,便血3例(7.9%),均为便后少量出血,术前便秘13例术后均获得明显改善。结论:吻合器痔上黏膜环形切除术结合血栓取出术治疗急性嵌顿性环状混合痔具有安全、有效、术后痛苦少等优点。

Objective To investigate the feasibility and clinical value of procedure for prolapse hemorrhoids with embolectomy surgery for acute incarceration of circumferential mixed hemorrhoids. Methods Thirty-eight patients with acute incarceration of circumferential mixed hemorrhoids underwent combined therapy form January 2004 to August 2005. The symptom, complications, and patient satisfaction were followed up. Results The mean postoperative hospital stay was 4 days. The mean operative time was 17. 4 minutes. After the procedure, 76. 3% of the cases occurred hemorrhoids echoplex, and no edema. On the fist day after the procedure,pain in 23.7% cases needed the body medicine management. Abdominal distention and pain （71. 1%）, and retention of urine （15.8%） were the main complications. After a mean follow-up time of 21.3 weeks, only 7.9% of the cases had a little bleeding and most recovered well with no recurrence, defecation, and continence. Constipation after the procedure was obviously improved. Conclusion The combined procedure for prolapse hemorrhoids with embolectomy surgery for acute incarceration of circumferential mixed hemorrhoids is effective, safe with minimally invasion.