经吻合器痔上黏膜环切术治疗重度痔的临床疗效观察

Observation on Clinical Efficacy of the Procedure for Prolapse and Hemorrhoid in the Treatment of Severe Hemorrhoids

【目的】探讨吻合器痔上黏膜环切术治疗重度痔的临床疗效。【方法】将2011年5月至2013年6月期间本院收治的Ⅲ度以上痔患者随机分成两组，对照组和观察组各120例。对照组采用外剥内扎术治疗，观察组则采用经吻合器痔上黏膜环切术治疗。比较两组间疗效及手术时间、住院时间、并发症发生率差异，采用视觉模拟评分法（VAS）对术后6 h、24 h及一周后排便的疼痛情况进行评分，比较组间差异。【结果】观察组痊愈率63．33％（76/120）和总有效率94．17％（113/120）显著高于对照组61．67％（62/120）和80．03％（97/120），且两组相比较差异均有显著性（P ＜0．05）。观察组手术时间、住院时间显著短于对照组（P ＜0．05）；观察组术后出血发生率显著低于对照组（P ＜0．05），观察组肛门狭窄、肛周红肿、尿潴留等其余并发症发生率低于对照组（P ＞0．05）。观察组术后6h、24h肛门疼痛评分及一周后排便疼痛评分显著低于对照组（P ＜0．05）。【结论】采用吻合器痔上黏膜环切术治疗重度痔疮疗效确切，术后恢复快，患者疼痛轻且并发症发生率低。

[Objective] To explore clinical efficacy of the procedure for prolapse and hemorrhoid（PPH） in the treatment of severe hemorrhoids .[Methods] The patients with severe hemorrhoids in our hospital from May 2011 to June 2013 were randomly divided into two groups with 120 patients in each group .The control group underwent Milligan-Morgan operation ,while the observation group underwent PPH .The efficacy ,operation time ,hospitali-zation time and the incidence of complications were compared between two groups . The visual analogue scale （VAS） was used to evaluate the pain at 6h and 24h after operation and a week after defecation .The difference be-tween two groups was compared .[Results] The curative rate and total effective rate in observation group were 63 .33% （76/120） and 94 .17% （113/120） respectively ,which were markedly higher than those in control group [61 .67% （62/120） and 80 .03% （97/120）] ,and there was significant difference（ P 〈0 .05） .The operation time and hospital stay in observation group were markedly shorter than those in control group （ P 〈0 .05） .The inci-dence of postoperative bleeding in observation group was markedly lower than that in control group （ P 〈0 .05） . The incidence of anal stenosis ,anal irritation ,urinary retention and other complications in observation group was lower than that in control group（ P 〉0 .05） .Anal pain scores in observation group at 6h and 24h after operation and a week after defecation were markedly lower than those in control group （ P〈0 .05） .[Conclusion]PPH for the treatment of severe hemorrhoids is effective with rapid postoperative recovery ,less pain and low incidence of com-plications .