痔上黏膜环切术与Milligan—Morgan术近远期疗效及并发症的对照研究

Comparison of the short - term and long - term therapeutic efficacy and complications between procedure for prolapse and hemorrhoids and Milligan -Morgan hemorrhoidectomy

目的比较痔上黏膜环切术（PPH）与Milligan—Morgan术（MMH）在近远期疗效差异。方法搜集南京市中医院全国肛肠医疗中心2007年2月至2008年3月行PPH与MMH的98例患者的临床资料，PPH组48例，MMH组50例，并进行随访，主要指标为近远期并发症、住院费用、生活质量及术式满意度。结果PPH在术后24h疼痛评分、术后水肿评分、尿潴留评分及术后满意度上与MMH差异无统计学意义（P〉0．05），在术后复发率、住院时间、住院费用、术后远期并发症发生情况上差异有统计学意义（P〈0．05）。结论PPH术后患者的住院时间明显短于MMH，且术后24h疼痛、水肿、尿潴留方面较MMH无优势，而住院费用明显高于MMH，MMH在术后复发率及远期并发症发生率较PPH更低。

Objective To compare the short - term and long - term therapeutic efficacy and complications between procedure for prolapse and hemorrhoids （PPH） and Milligan - Morgan hemorrhoid- ectomy（MMH）. Methods Clinical data were collected about the patients who underwent PPH or MMH between February 2007 and March 2008 in the National Center for Colorectat Diseases, Nanjing municipal hospital of Traditional Chinese Medicine. A total of 98 patients were involved, including 48 in PPH group and 50 in MMH group. The measures for comparison consisted of short - term and long - term complications, quality of life, surgical satisfaction and hospital cost. Results There were no significant differences in 24 - hour pain score, postoperative edema, postoperative uroschesis and surgical satisfaction between PPH and MMH（P 〉0.05）. The recurrence rate and longterm complications of PPH were significantly higher than those of MMH（P 〈0.05）. Hospital stay in the PPH group was much shorter than in the MMH group（ P 〈 0.05 ）and hospital cost in the PPH group higher than in the MMH group （P 〈 0.05 ）. Conclusion PPH is not better than MMH in the short - term and long - term therapeutic efficiency and complications except the shorter hospital stay.