三种荷包缝合技术在PPH痔疮治疗的临床效果

Clinical Effect of 3 Different Kinds of Technique of Purse-string Sutures in Procedure for Prolapse and Hemorrhoids

目的:比较三种不同的吻合器痔上粘膜环形切除钉合术(procedure for prolapse andhaemorrhoids,PPH)手术的荷包缝合法及效果。方法:采用单荷包单圈缝合法(A组)、双荷包双圈缝合法(B组)以及双半荷包单圈缝合法(C组),对120例Ⅲ、Ⅳ度环状脱垂性内痔行PPH术,比较分析三组病例的手术时间、术中下腹部疼痛、切除直肠粘膜宽度、粘膜环完整性及均匀度、痔核回缩、吻合口部位、术中出血、痔核回缩度、术后肛门疼痛、术后出血及住院时间。结果:双半荷包单圈缝合后切除的直肠粘膜宽度cm、粘膜环完整性及均匀度、痔核回缩与双荷包双圈缝合法无显著性差异,优于单荷包单圈缝合法(P<0.05);双半荷包单圈缝合法及单荷包单圈缝合法手术时间较双荷包双圈缝合法时间缩短(P<0.05);术后肛门疼痛、术后出血及住院时间三组无显著性差异(P>0.05)。结论:双半荷包单圈缝合法能保证PPH手术切除直肠粘膜宽度、粘膜环完整性及均匀度、痔核回缩明显,且不增加手术程序及手术时间、具有一定的临床推广价值。

Objective：To compare a suitable technique of purse-string suture in procedure for prolapse and hemorrhoids（PPH）.Method： 120 cases of Ⅲ and Ⅳ degree prolapsed hemorrhoids were treated by PPH.Group A was with traditional single purse-string suture,group B with double purse-string suture and group C with double half purse-string suture.Result： The indexes of width of excised rectum mucosal ring,the correction of prolaposed hemorrhoid and resection of regular mucosa circulus in group B and C were significantly superior to that in group A（P 0.05）,while there is no difference between group B and C.The operation time,postoperative anal pain hospital stay showed no significant differences among 3 groups（P0.05）.Conclusion： The results of procedure with double half purse-string suture were good in width of excised rectum mucosal ring,resection of regular mucosa circulus and integrity and retraction of haemorrhoids.It won＇t prolong the operation time.It has a significant value to be utilized clinically.