外剥内扎合弧形切口皮桥游离术治疗环状混合痔临床研究

Clinical Study on External Dissection & Internal Ligation plus Arc Incision & Skin Bridge Drifts Away in Treatment of Circular Mixed Hemorrhoids

目的:探讨能减少环状混合痔术后并发症、降低痔复发率的手术方式。方法:将148例环状混合痔患者随机分为治疗组与对照组各74例,治疗组在对照组外剥内扎术治疗基础上加用弧形切口皮桥游离术,比较两组疗效、伤口愈合时间、术后并发症及复发率。结果:两组疗效均为100%;两组伤口愈合时间分别为(13.5±3.2)天、(16.8±3.1)天;术后切口水肿分别为21例、56例,残留皮赘分别为5例、31例;肛门狭窄分别为1例、15例;半年复发分别为4例、14例;两组伤口愈合时间及治愈率无显著差异(P>0.05),但术后并发症、复发率有明显差异(P<0.05)。结论:外剥内扎合弧形切口皮桥游离术可以减少环状混合痔外剥内扎术术后残留皮赘、切口水肿及肛门狭窄等并发症,降低痔复发率,是一种较为理想的手术方式。

Objective： To investigate the operation way to reduce the circular mixed hemorrhoids complications and cut down the relapse rate. Methods： The 148 cases was randomly divided into the treatment group and the control group , each group has 74 patients . Patients in the control group were treated with external dissection ＆ internal ligation. Are incision ＆ skin bridge drifts away was added to the treatment group. Comparison the curative effects , the Wound healing time, the complications and the relapse rate. Results： The curative effects were 100% in each group,The Wound healing time were （ 13.5± 3.2） days and （ 16.8± 3.1 ） days. The incision edema cases were 21 and 56, The remained abnormal outgrowth skin cases were 5 and 31, The anal narrow cases were 1 and 15, the relapsed cases after six months were 4 and 14. It showed that there was no significant difference in the curative effects and the Wound healing time（ P 〉 0.05 ） ,but there was significant difference in the complications and the relapse rate between the two groups （ P 〈 0.05 ）. Conclusion ： The external dissection ＆ internal ligation plus arc incision ＆ skin bridge drifts away can reduce the complications after the operation of the circular mixed hemorrhoids , such as the remained abnormal outgrowth skin, the incision edema and the anal narrow, And cut down the relapse rate of hemorrhoids, It is an ideal operation way for circular mixed hemorrhoids.