开环式微创痔吻合器治疗重度脱垂痔的临床研究

Study on the TST in treatment of severe prolapsed hemorrhoids

目的采用开环式微创痔吻合器(TST)治疗重度脱垂痔的临床疗效。方法将58例Ⅲ期-Ⅳ期混合痔及内痔患者实施TST手术与痔上黏膜环形切除吻合术(PPH)60例进行手术疗效进行比较分析。结果 TST方法较PPH有更少的术中出血(P<0.05);视觉模拟疼痛评分法(VAPS)显示TST组和PPH组分别为1～3分和4～6分,两组差异有统计学意义(P<0.05),术后两组肛管静息压及直肠静息压无明显差异(P>0.05),达到手术的疗效标准。术后随访6个月,没有肛门狭窄及肛门直肠吻合口感染或肛周脓肿发生,未见痔核脱垂及其它病理征候。结论 TST治疗重度混合痔总体效果与PPH相当,具有安全、疗效可靠及低并发症,但有更少出血。

Objective To investigate the efficacy of TST （tissue-selecting therapy stapler） in the treatment of severe prolapsed hemorrhoids. Methods Fifty-eight cases with m or IV degree hemorrhoids were operated by TST procedure and 60 cases were operated by PPH. The operative effects were analyzed comparatively. Results Blood loss in PPH group and rUST group were 18.55±3.19 mL and 10.17±2.82 mL, and there was significant difference between two groups （P〈0.05）. VAPS score in PPH and TST group were 1-3 and 4-6, and the differences were significant between two groups. However, the anal resting pressure and rectal resting pressure had no significant difference before and after operation. All the patients were followed-up for 6 mouths. No case had anal stenosis, infection or perianal abscess. Conclusion In the curative effects, TST is similar to the PPH procedure in the treatment of severe prolapsed hemorrhoid and it has safety, reliable, lower complications and less blood loss.