不同荷包高度对PPH术前后肛管直肠压力及疗效的影响

Clinical observation the impact of measure of pressure of anus and clinical efficacy before and after the Procedure for Prolapse and Hemorrhoids in the different pursestring height

目的探讨痔PPH术中,不同荷包高度的选择对手术前后肛管直肠压力及疗效的影响。方法选择混合痔住院手术患者60例,随机分为3组,每组各20例,3组均采用PPH术,手术操作中采用不同荷包高度。分别对3组患者术中切除黏膜宽度、手术前后肛管直肠压力、术后并发症及疗效等指标进行临床观察统计。结果 3组患者的近期临床疗效、术中切除黏膜宽度、肛管静息压、术后疼痛及急便感的比较差异有统计学意义(P<0.05)。结论 PPH术中荷包高度选择在齿线上2～3cm,为适合国人的最佳PPH术选择荷包高度。肛管直肠测压为评定肛肠手术前后的肛管直肠动态功能提供科学客观的标准,对肛管直肠功能的鉴定有重要的指导意义,并可用于指导临床改进手术方式。

Objective This study is to extrapolate the different pursestring height during performing the Procedure for Prolapse and Hemorrhoids （PPH）, and to access the impact of measure of pressure of anus and Clinical efficacy. Methods Sixty samples are divided into three groups（ n = 20） randomly. The three groups adopt the Procedure for Prolapse and Hemorrhoids hut each group adopts the different pursestring height. Observing and analyzing the clinical curative effect, the mucosal width, pressure of anus （before and after）, postoperative complications. Results Three groups have significant difference in the clinical cur- ative effect, the mucosal width, before and after operation anal resting pressure and treatment, postopera- tive complications （ P 〈0.05}. Conclusion According to our study , pursestring height in the 2~3 cm a- bove the dentate line in the Procedure for Prolapse and Hemorrhoids is the most suitable height for our Chinese, hemorrhoid anastomosis purse height selection. Anorectal manometry to evaluate the measure of pressure of anus before and after anorectal operation provide scientific and objective standard, and can be used to guide the clinical operation improvement.