两种术式治疗混合痔的疗效比较

A Comparative Study on Two Surgical Procedures for Mixed Hemorrhoids

为探讨自动痔疮套扎术（RPH）联合外痔切除术与外剥内扎术治疗Ⅱ、Ⅲ期内痔为主的混合痔的临床疗效，采用RPH联合外痔切除术治疗该类混合痔65例（观察组），与同期单纯采用外剥内扎术治疗55例（对照组）进行比较，在平均单个痔手术时间、住院时间、创口愈合时间、水肿发生例数、术后出血评分、术后尿潴留例数、疼痛评分、术后1年复发例数方面评价两组的治疗效果。结果显示，观察组可缩短单个痔手术时间、住院时间及创口愈合时间，且可明显减轻术后疼痛、创缘水肿及术后出血，优于对照组（P〈0．05）。而术后1年复发率、术后尿潴留情况两组比较无统计学意义（P〉0．05）。结果表明，在治疗Ⅱ、Ⅲ期内痔为主的混合痔时可优先选择RPH联合外痔切除术，以加快患者术后恢复，减轻术后并发症。

Abstract This study was to observe the clinical efficacy of Ruiyun procedure for hemorrhoids（RPH） combined with external hemorrhoidectomy versus external dissection and internal ligation for mixed hemor- rhoids of stage Ⅱ ,Ⅲ which dominated by internal hemorrhoid. Observation group （ n= 65） underwent RPH combined with external hemorrhoidectomy,while control group（ n = 55） received external dissection and internal ligation. Both groups were evaluated for curative effect through comparing operation time of a single hemorrhoid, hospital stay, wound healing time and the number of cases with edema and postoperative urinary retention, postoperative bleeding scores, pain scores, the number of relapsed cases within one year. The results showed that observation group could shorten the operation time for a single hemorrhoid, hospi- tal stay,and wound healing time,and obviously reduce postoperative pain,wound margin edema and post- compared and operative bleeding, which was superior to control group（ P 〈0.05）. There was no significant difference between the two groups in one-year relapse rate and postoperative urinary retention （P 〈0.05）. It is concluded that RPH combined with external hemorrhoidectomy may be the preferred choice for mixed hemorrhoids of stage Ⅱ ,Ⅲ, which dominated by internal hemorrhoid, for it can improve recovery and reduce complications.