单次法和二次法吻合器痔上粘膜环切术治疗重度痔病的临床研究

Clinical Study of Operative of Procedure for Prolapse and Hemorrhoids and Repeated PPH in Treating Severe Hemorrhoid

目的：对比研究吻合器痔上粘膜环切术（PPH，A组）与二次法吻合器痔上粘膜环切术（B组）在重度痔病的治疗效果。方法：对我院手术治疗的77例重度痔病患者（其中40例行痔上粘膜环切术，37例行二次法吻合器痔上粘膜环切术）的病历资料进行了回顾分析，并对术中术后多项指标进行评估。结果：两组患者手术时间分别是19．54min和33．01rain，术后24h疼痛平均评分分别是4．14和5．52，平均随访期为12月（3～15个月），术后1月内患者排便不适感B组略多于A组，A组复发率为7．5％，B组为0，两组均无大便失禁、肛门狭窄发生。结论：单次法吻合器痔上粘膜环切术手术方式简单有效，但重度痔疮复发率较高，而二次法吻合器痔上粘膜环切术虽操作稍复杂，但由于切除痔上粘膜较多。对重度痔疮疗效较好。

Objective： To assess the clinical effect of treating hemorrhoids through the operative of procedure for prolapse and hemorrhoids （ PPH, A group） and repeated PPH （ B group ）. Method ： Total 97 patients with third or fourth degree hemorrhoids were operated by PPH （40 patients） or repeated PPH （37 patients）, then evaluated multiple index between the two groups. Result： The operation lasted for an average 19.54 minutes and 33.01 minutes, the average pain score at 24 hours after operation were 4.14 and 5.52 respectively. Mean follow- up were 12 months （3 -15 ）. A group 7.5% ,B group 0. No incontinence, stenosis was found in either group. Conclusion： Both technique are simple, safe, effective and rapid, causing minimum or no postoperative pain, repeated PPH is more effective option in treating severe irreducible prolapsed piles than PPH, The Long- term results need further study.