经肛门吻合器痔上黏膜环切术治疗Ⅲ、Ⅳ度痔临床分析

Clinical analysis of hemorrhoid stapler through the anus mucosal resection treatment of grade Ⅲ, Ⅳ degree hemorrhoids

目的:探讨经肛门吻合器痔上黏膜环切术治疗痔的临床运用价值和经验。方法:对230例Ⅲ度、Ⅳ度痔采用经肛门吻合器痔上黏膜环切术患者的临床资料进行回顾性分析。结果:230例患者手术均成功,手术时间为10～15min,平均12.5min;住院时间及伤口愈合时间为2～5d,平均3.5d;恢复工作时间为5～7d,平均6d;2个月内肛门有不适感28例;术后疼痛时间为6～10h,平均8h;术后无肛门狭窄及大便失禁;术后1d尿潴留19例;术后1d内出血65例(纸染);术后随访6个月～1年无复发,排便功能不受影响。经X线片检查,吻合钉术后2个月开始排钉,大部分患者术后3～8个月吻合钉已排完,术后超过1年以上未排完者17例,最早1例3个月排完。结论:经肛门吻合器痔上黏膜环切术治疗Ⅲ度、Ⅳ度痔是一种安全、有效的方法,具有操作简单、手术时间短、术后疼痛轻、缩短住院时间及患者恢复周期短等优点。

Objective： To evaluate the clinical using value and experience of anal mucosal hemorrhoid stapler resection in the treatment of hemorrhoids. Methods： Two hundred and thirty cases of grade Ⅲ, Ⅳ degree hemorrhoid stapler through the anus using mucosal resection patients＇ clinical data were retrospectively analyzed. Results： 230 cases were all with successful surgery, the operative time were 10-15 minutes, an average of 12.5 minutes; hospital stay and wound healing time were 2-5 days, an average of 3.5 days; recovery time were 5-7 days, an average of 6 days; 2 months anal discomfort in 28 cases; postoperative pain time was 6-10 hours, an average of 8 hours; had no postoperative anal stenosis and fecal incontinence; after 1 day of urinary retention in 19 cases; after 1 day of bleeding in 65 cases （dyed paper ）; the patients were followed up for 6 months to 1 year without recurrence, bowel function was not affected. The X-ray examination were done, consistent with nails after 2 months of the beginning row of nails, the majority of patients after 3-8 months of consistent nail had been drained, 17 cases were not drained after more than one year, one case drained in the earliest 3 months. Conclusion： Hemorrhoid stapler through the anus mucosal resection treatment of grade Ⅲ, Ⅳ degree hemorrhoids is a safe and effective method. It has merit such as simple operation, shorter operative time, postoperative pain, shorter hospital stay and recovery period so on.