PPH术后并发症原因及策略

目的:PPH(吻合器痔上黏膜环切术)术并发症的原因及策略。方法:2004年7月至2009年10月对386例Ⅲ、Ⅳ度内痔病人行PPH术,分析术后发生并发症的原因及策略。结果:386例病人平均手术时间20min;术后1d发生疼痛的发生率21.1%,出血发生率5.8%;4～12周再出血率9.8%(38/386)。2例发生吻合口狭窄,分别发生在3、10个月。平均随访时间36±5.6个月,随访率为89.4%(345/386,),3例严重脱垂内痔病人做第2次PPH术,其余病人均无复发。结论:PPH具有手术时间短、创伤小、恢复快、并发症少等优点,术后只要能正确处理并发症,是治疗Ⅲ、Ⅳ度脱垂内痔的理想方法。

Objective：To access the reasons and countermeasure of the complications after procedure for prolapse and hemorrhoids（PPH）.Methods：Third hundreds eighty and six cases ofⅢ-andⅣ-degree hemorrhoids were treated with PPH from July2004 to October 2009.The reassons and countermeasure of the complications were analyzed.Results：Of the 386 patients,the mean operation time was 20 min.In the next day after procedures,pain rate was 21.1% and the bleeding rate was 5.8%.9.8%（38/386） of patients had re-bleeding 4～12w after procedures.Only 2 patients were found stricture in rectum3,10 months after the procedure.In 345 followed-up patients（345/386,89.4%）,there were only 3 severe patients had twice of procedure and no recurrence in other patients.Conclusion：PPH is effective,safe,minimal invasive method and is the ideal choice to treat severe hemorrhoids.