保存肛垫错位断桥缝合术治疗环状混合痔的临床研究

Clinical Study on the Procedure of Saving Anocushion,Transposing Incision of Skin Bridge and Suture in the Treatment of Circumferential Mixed Hemorrhoids

为探讨疗效好、并发症少的治疗环状混合痔的新术式，采用保存肛垫错位断桥缝合术治疗环状混合痔108例（治疗组），以外剥内扎术治疗环状混合痔50例作为对照组，对比观察两组临床疗效、创面愈合时间、肛门功能、术后并发症等指标。结果显示，治疗组治愈106例（98．2％），对照组治愈42例（84．0％）。治疗组创面愈合时间为（16±7）d，对照组（24±5）d（t=7．26，P〈0．01）。肛管静息压：治疗组术前（11．7±1．2）kPa，术后（6．7±2．0）kPa（t=22．28，P〈0．01）；对照组术前（11．6±2．0）kPa，术后（9．5±1．3）kPa（t=9．48，P〈0．01）。治疗组术后无肛门狭窄和水肿，对照组分别为4例（8％）和10例（20％）（Χ^2=11．24，P〈0．01）。术后24h排尿困难治疗组9例（8．3％），对照组11例（22．0％）（Χ^2=37．75，P〈0．01）。术后肛门下坠治疗组0例，对照组7例（14．0％）（Χ^2=4．28，P〈0．05）。结果表明，保存肛垫错位断桥缝合术治疗环状混合痔较外剥内扎术可提高治愈率，缩短创面愈合时间，保存肛门正常生理结构和功能，减少术后并发症。

The new surgical procedure of saving anocushion,transposing incision of skin bridge and suture was applied to treat circumferential mixed hemorrhoids. 108 cases underwent the procedure （the trial group） and 50 cases underwent the traditional procedure of external dissection ＆ internal ligation （the control group）. As results,the cure rate and the wound healing time was 98.2% （106/108） and 16±7days in the trial group as compared with 84. 0% （42/50） and 24±5 days in the control group（t =7. 26, P 〈 0.01）. The preoperative anal rest pressure was （11. 7±1.2）kPa and the postoperative anal rest pressure was （6.7±2.0）kPa（ t= 22.28, P 〈0. 01） in the trial group against （11.6±2.0）kPa and （9.5±1.3）kPa （ t =9.48, P 〈0.01） in the control group. There was no postoperative anal edema and stricture in the trial group,while stricture and edema occurred in 4 cases（8.0%） and 10 cases（20.0%） respectively in the con- trol group（Χ^2=11. 24, P 〈0.01）. Dysuria occurred within 24 hours postoperatively was found in 9 cases （8.3%） inthetrialgroup,while ll cases（22.0^） inthecontrolgroup（Χ^2= 37.75, P〈0.01）.Noanaltenesmus occurred postoperatively in the trial group,while that occurred in the control group was found to be 7 cases（14.0%） （Χ^2=4.28, P 〈0.05）. These showed that this new procedure has many strong points, such as higher cure rate,shorter healing time,reservation of anal function and less postoperative complications.