摘要
目的 比较痔上直肠黏膜环切术(PPH)与Milligan-Morgan痔切除术(MMH)对Ⅲ、Ⅳ度环状痔的远期疗效。方法回顾性分析2001年10月至2003年7月收治的Ⅲ、Ⅳ度环状内痔或以内痔为主的环状或近环状混合痔并获得随访5年以上的114例患者的临床资料,其中43例行PPH(PPH组),71例行MMH(MMH组)。结果PPH组术后晚期出血5例,MMH组无术后晚期出血病,例(P〈0.05);PPH组术后痔脱垂复发9例,MMH组5例(P〈0.05)。PPH组直肠颈压力术前,术后6个月、1年、3年分别为(122.0±11.3)、(90.0±10.4)、(103.0±13.8)、(113.0±11.2)cmH2O(1cmH2O=0.098kPa);MMH组分别为(126.0±13.5)、(91.0±12.4)、(78.0±9.8)、(81.0±7.5)cmH2O。PPH组术后6个月直肠颈压力较术前明显降低(P〈0.05),MMH组术后6个月、1年、3年直肠颈压力均较术前明显降低(P〈0.05)。结论PPH安全、近期疗效好,但晚期出血及肛门疼痛较多,远期复发率较高。
Objective To compare the long-term effects between procedure for prolapse and hemorrhoids (PPH) and Milligan-Morgan hemorrhoidectomy (MMH) in the treatment of Ⅲ and Ⅳ degree of hemorrhoids. Method The clinical data of 43 cases with Ⅲ and Ⅳ degree hemorrhoids received PPH (PPH group)and 71 cases received MMH (MMH group) were analyzed retrospectively from October 2001 to July 2003. Results Late bleeding in 5 cases of PPH group and no one of MMH group (P 〈0.05). Hemorrhoidal recurrence prolapsed in 9 cases of PPH group and 5 cases of MMH group (P 〈 0.05). The rectal neck pressure preoperative,after 6 months, 1 year and 3 years were (122.0 ± 11.3), (90.0 ±10.4), (103.0 ± 13.8) and (113.0 ±11.2) cm H2O (1 cm H2O =0.098 kPa) of PPH group,after 6 months was decreased obviously than preoperative (P 〈 0.05 ), and they were (126.0 ± 13.5 ), (91.0± 12.4), (78.0 ± 9.8) and (81.0 ± 7.5) cm H2O of MMH group,after 6 months, 1 year and 3 years were decreased obviously than preoperative (P 〈 0.05). Conclusion PPH is safety and effect at short time,but it brings more late bleeding and anal pain, and its rate of prospective hemorrhoidal recurrence is more higher than MMH.
出处
《中国医师进修杂志》
2010年第26期26-28,共3页
Chinese Journal of Postgraduates of Medicine