吻合器痔上黏膜环切吻合术治疗环状混合痔123例临床疗效观察

The clinical effect of treatment of prolapse and hemorrhoids for 123 circumferential mixed cases

目的观察吻合器痔七黏膜环切吻口术（PPH）治疗Ⅲ、Ⅳ期环状混合痔的疗效。方法应用吻合器治疗123例Ⅲ、Ⅳ期混合痔患者，观察术后疗效及不良反应。结果123例患者平均住院天数为5d，平均手术时间为21min；术中吻合旧渗血21例，占17％；术后2-3d大便出血3例；术后12-15d钛钉脱落2例；术后当日尿潴留28例；5例因疼痛出现排尿困难；术后当日肛门疼痛12例，恶心5例，下腹坠胀79例。随访1～6个月，1例吻合口狭窄。结论吻合器痔E黏膜环切吻合术治疗Ⅲ、Ⅳ期环状混合痔具有手术时间短、创伤小、痛苦少、恢复快、并发症少的优点。

Objective To observe the clinical effect of the treatment of prolapse and hemorrhoids for Ⅲ - Ⅳcircumferential mixed. Methods One hundred and twenty - three cases of stapler treatment of mixed hemorrhoids Ⅲ - Ⅳ patients and adverse effects were observed. Results One hundred and twentythree patients＇ average hospital stay was 5 days, average operation time 2 l nfin; intraoperative anastomotic bleeding in 21 cases, 17 % ; after 2-3 days 3 cases of bleeding in stool efforts; after 12 to 15 days 2 cases＇ titanium screw off; 28 cases of urinary retention after the day; 5 cases pain and dysuria; and anal pain the day after surgery in 12 cases, nausea in 5 cases, 79 cases of lower abdominal bulge. Following up 1 to 6 months, 1 case of anastomotic stenosis. Conclusion Procedure for prolapse and hemorrhoids on the mueosal anastomosis Ⅲ - Ⅳ of circumferential mixed has shorter operative time, less trauma, less pain, faster recovery, less complication.