PPH与Milligan-Morgan手术治疗重度痔的疗效比较

Procedure for Prolapse and Hemorrhoids Versus Malligan-Morgan Hemorrhoidectomy in Treatment of Severe Hemorrhoids

目的:比较PPH与Milligan-Morgan手术治疗重度痔的疗效。方法:将130例重度痔患者半随机分为治疗组(PPH)和对照组(Milligan-Morgan术),分别采用相应的方法治疗,对比观察两组的手术时间、住院时间、住院费用、创面愈合时间、治疗有效率和术后近期及6～24个月后并发症、肛门功能等指标。结果:两组手术有效率无统计学差异(P>0.05),治疗组手术时间、平均住院日、创面愈合时间明显低于对照组(P<0.01);术后并发症发生率(疼痛、肛缘水肿、出血等)低于对照组(P<0.01),肛门功能恢复优于对照组(P<0.05),住院费用、术后肛门坠胀、下腹疼痛发生率高于对照组(P<0.01)。术后6～24个月肛门狭窄、瘙痒和残留皮赘发生率两组差异均无统计学意义(P>0.05)。结论:PPH治疗重度脱垂痔的近期疗效明显优于Milligan—Morgan手术,但费用较大,远期疗效尚需进一步追踪随访。

Objective To compare the therapeutic effects of severe hemorrhoids between procedure for prolapse and hemorrhoids （PPH） and Milligan-Morgan （M-M） hemorrhoidectomy.Methods One hundred and thirty cases of hemorrhoids were randomly divided into two groups：a treatment group （PPH） and control group （M-M）.Operating time,hospital stay,hospital expenses,wound healing time,treatment efficiency and postoperative complications as well as anal function in each group were compared.Results The efficiency of the operation in each group presented no statistical difference （P 0.05）.The operating time,hospital stay,hospital expenses and wound healing time in the treatment group were significantly lower than those in the control group;the postoperation morbidity rates （pain,anus edema,bleeding） in the treatment group were significantly lower than those in the control group （P 0.01）;and anal function restoration was better in PPH group than that in M-M group （P 0.05）.But hospital expenses,postoperative tenesmus sensation of the anus and rates of lower abdominal pain in the treatment group were higher than those in the control group （P 0.01）.After 6～24 months the incidences of anal stenosis,anal prutitus and residual tag in two groups presented no statistical differences （P 0.05）.Conclusion PPH presents significantly better therapeutic effect on severe hemorrhoids compared with Milligan-Morgan,but costs higher expenses.