PPH术治疗环状痔的临床研究

Clinical study of procedure for prolapse and hemorrhoids in the treatment of circumferential hem- orrhoids

目的探讨吻合器痔上黏膜环切术（PPH术）治疗环状痔的临床疗效。方法将198例患者随机分为对照组99例和治疗组99例，对照组采用外剥内扎术，治疗组采用PPH术。观察记录手术疗效及术中出血量、手术时间、术后疼痛时间、创面愈合时间。结果治疗组总有效率99％（98／99），显著高于对照组89．9％（89／99），P〈0．05；治疗组术中出血量（25．6±1．7）ml、手术时间（42．5±6．4）min、术后疼痛时间（2．4±0．5）h、创面愈合时间（7．2±0．9）d均明显优于对照组（80．3±2．6）ml、（92．4±6．1）rain、（4．5±0．8）h、（10．5±0．7）d，P〈0．05。结论PPH术较外剥内扎术明显提高环状痔治疗有效率，显著改善患者术后愈合情况，提高临床治疗效果。

Objective To explore the therapeutic efficacy of procedure for prolapse and hemor- rhoids （PPH） in the treatment of circumferential hemorrhoids. Methods A total of 198 patients were ran- domly divided into control group（ n = 99 ）and treatment group（ n = 99 ）. The traditional approach as exter- nal dissection and internal ligation was used in control group, and PPH was applied in treatment group. The clinical therapeutic effect, bleeding volume, operative time, postoperative pain time, and healing time of wound surface were observed and recorded. Results In treatment group the total effective rate was signifi- cantly higher than in control group [ 99% （ 98/99 ） vs. 89.9% （ 89/99 ） , P 〈 0.05 ] ; The bleeding volume [ （ 25.6 ± 1.7 ） ml ], operative time [ （42.5 ± 6.4 ） min ], postoperative pain time [ （ 2.4 ± 0.5 ） h ], and healing time of wound surface [ （7.2 ± 0.9） d ] were significantly less than control group [ （ 80.3±2.6） ml,（92.4±6.1）min,（4.5±0.8）h,（10.5±0.7）d,P〈0.001）].Conclusion PPH in the treatment of circumferential mixed hemorrhoids has satisfying clinical therapeutic effect, and is significantly superior to the procedure of external dissection and internal ligation in terms of effective rate and postoperative re-