吻合器痔上黏膜环切术缝线位置与深度对混合痔疗效的影响

Influence on Therapeatic Effect of the Suture Position and Depth of PPH in Treatment of Mixed Hemorrhoids

为探讨行吻合器痔上黏膜环切术（PPH）时荷包缝合线的位置对混合痔疗效的影响，选择45例重度混合痔患者于齿状线上2．5～3cm做荷包缝合（观察组），45例选择齿状线上3～3．5cm做荷包缝合（对照组）。两组疼痛程度及治愈率无明显差异，但观察组便血、痔脱垂及并发症明显减少，痔核回缩效果明显。结果表明，PPH荷包线位置选择在齿状线上2．5～3cm，深度包括直肠黏膜层时，近期疗效较好，具有手术时间短，术后疼痛轻，并发症少，恢复快等优点。

The objective of this study was to evaluate the influence on therapeutic effect of the purse-string suture position of PPH in treatment of mixed hemorrhoids. The 45 patients with severe mixed hemorrhoids underwent the purse-string suture 2.5-3 cm above the dental line（the observation group）,and another 45 patients underwent the purse-string suture 3-3.5 em above the dental line（the controlled group）. As resuits,there was no notable difference in pain extent and cure rate between the two groups ; while there was an obvious reduction in hematochezia, hemorrhoidal prolase and complications in the observation groups; and marked retraction of the hemorrhoids was also noticed in the observation group. It is concluded that the short therapeutic result was better when the purse-string suture in PPH was 2.5-3cm above the dental line and the suture depth is to involve the rectal mucosa;and this suture（2.5-3cm above dental line） is proved to be shorter in operation time,less in postoperative pain,less in complication and faster in recovery.