PPH治疗重度脱垂痔506例临床分析

PPH in the Treatment of Severe Prolapsed Hemorrhoids：Clinical Analysis on 506 Cases

为探讨吻合器痔上黏膜环切术（PPH）治疗重度脱垂痔的效果，对506例重度脱垂痔患者行PPH。结果显示，504例患者一次吻合成功，2例患者吻合毕发现吻合口裂开行手法缝合。手术时间10－20min，平均15min；住院时间3～7d，平均4d。术后246例患者庖用镇痛剂，3例患者术后3～7d突发出血（200ml以上）。随访12～36个月，502例患者痔核完全回缩，有效率100％，满意度为96．0％（486／506）。本组病例无肛门狭窄发生。结果表明，PPH手术创伤小、手术时间短、患者疼痛轻、住院时间短、恢复快、无肛门狭窄等并发症，是治疗重度脱垂痔的理想术式。

The aim of this study was to investigate the curative effect of PPH for severe prolapsed hemorrhoids. The 506 patients received PPH,among whom 504 cases were primarily anastomosed successfully, rest two cases again received maneuver suture due to stoma rupture;operative time was 10-20 rain（averaged 15 min） ,hospitalization duration was 3-7 days（averaged 4 days） ;after operation 246 cases used analgesic,in 3 cases bleeding（〉 200ml） oceured suddenly later 3-7 days after operation; follow-up of 12-36 months found that in 502 cases their hemorrhoids mass constricted back;effective rate was 100% ,patient＇s satisfactory degree was 96.0%（486/506）;no anal stenosis was found. Results show that because of less trauma, shorter operative time,milder pain of patient,shorter hospitalization duration,faster recovery and no anal stenosis,PPH just is an ideal procedure for severe prolapsed hemorrhoids.