PPH加外痔切除缝合术治疗重度混合痔63例临床观察

PPH plus Resection ＆ Suture for External Hemorrhoids in the Treatment of Severe Mixed Hemorrhoids of 63 Cases

为探讨PPH加外痔切除缝合术治疗重度混合痔的临床疗效，回顾分析行PPH加外痔切除缝合术治疗的63例重度混合痔患者资料。结果显示，63例患者均顺利完成手术，手术时间为17～34min，平均（25．8±4．1）min；术中出血量为5～25ml，平均（14．0±4．5）ml；住院时间为9～12d，平均（10．3±0．9）d。术中牵拉荷包线、击发吻合器时感下腹胀痛不适者3例，术后均自行缓解。术后发生尿潴留5例（7．9％）；肛门坠胀不适感6例（9．2％），半个月后肛门坠胀感消失；术后外痔切除缝合切口感染1例，经换药、坐浴治疗10d后好转。全组患者术后无出血发生。术后随访6个月，均无复发，均无肛门狭窄、大便失禁等后遗症，肛门外观较平整。结果表明，PPH加外痔切除缝合术治疗重度混合痔方法简单易行，术后患者疼痛轻、恢复快、并发症少，值得临床推广应用。

In order to investigate the clinical effect of PPH plus resection ＆ suture for external hemor- rhoids for treating severe mixed hemorrhoids ,authors retrospectively analyzed the data of 63 patients with this hemorrhoids who had received this combined procedure. As results, in the 63 cases all smoothly was performed this procedure,the time for operation was 17-34min,averaged （25.8±4.1） min,the intraoperatire bleeding volume was 5-25ml（averaged 14.0ml±4.5ml）, the hospitalization time was 9-12d（averaged 10.3d-0.9d） ;during operation when pull purse-string thread as well fire stapler 3 cases had swelling-pain uncomfort feeling at lower abdomen,after operation all self-relieved;after operation uroschesis occured in 5 cases（7.9%）, 6 cases （9. 2%） had tenesmus uncomfort feeling, but half month later the feeling disap- peared, external hemorrhoids wound infection occured in one case then improved through dressing changes and sitz bath for 10 days^in all of patients no postoperative bleeding occured; postoperative follow-up of 6 months did not find recurrent cases, stenosis of anus and incontinence of stool, etc, and the anal appearance was more smooth and intact. Results show that above-mentioned procedure is simple and easy to manipulate,and after performing it patient＇s pain is mild,recovery fast,and complication less, thus worthy to be popularized clinically.