微创治疗环状混合痔疗效观察

Therapeutic Effect Observation on Microsurgery for Circumferential Mixed Hemorrhoids

为探索环状混合痔的做创手术治疗方法，将混合痔96例随机分为治疗组50例，对照组46例，分别采用小切口肛垫固托术与传统外剥内扎术进行临床对比观察。结果显示，手术时间、术中出血量、住院天数、疼痛分级、术后肛缘水肿例数各项指标，治疗组明显优于对照组（P〈0．01）。术后半年随访，两组痊愈、好转、复发率无显著性差异。结果表明，小切口肛垫固托术，内痔微创缝合，使肛垫复位、缩小，缝线及硬化剂的异物致炎刺激使痔组织与黏膜下层、肌层之间发生纤维化增生，瘢痕性粘连固化，闭塞、压迫肛垫内扩张变性的血脉网络，达到消除内痔病理状态的目的。外痔区微小切口减压，消除过多赘生外痔组织，外痔症状得到有效改善，临床疗效明显优于传统手术。

The aim of this study was to probe into the microsurgery therapy for circumferential mixed hemorrhoids. The 96 patients were random divided into treatment group （ n = 50） and controlled group（ n = 46）. The two groups received microsurgery fixation ＆ support of anal cushion or routine external dissection ＆ internal ligation respectively,and were compared each other clinically. As results,in operation time, operative bleeding volume,hospitalization duration（day）, pain degree, incidence of postoperative anus-edge edema, etc, treatment group were significantly superior to controlled group（ P 〈0.01）;the postoperative follow-up of 0.5 yr found there was not significant difference（ P 〉0.05） in cure rate,improvement rate and recurrence rate between both groups. These results show that micro-incision fixation ＆ support of anal cushion,microsurgery suture for internal hemorrhoids can reposite and shrink of anal cushion,inflammatory stimulus caused by foreign body of suture and hardening agents could produce fibrosis hyperplasia in hemorrhoids organization, submucosa and muscularis; cicatricial adhesion fixation; closed and oppress the enlarge and degeneration vascular network of anal cushions,eliminating the pathological situation of internal hemorrhoids. Decompression by micro-incisions in external hemorrhoids area, elimination of excess supernumerary external hemorrhoids organization, the symptoms of external hemorrhoids area could be improved,thus this therapy is significantly superior to traditional opeation.