选择性痔上黏膜切除术治疗重度混合痔的临床观察

Clinical observation of selective hemorrhoid mucosal resection in the treatment of severe mixed hemorrhoid

目的观察选择性痔上黏膜切除术(TST)治疗Ⅲ、Ⅳ度混合痔的临床疗效。方法将100例Ⅲ、Ⅳ度混合痔患者随机分为治疗组及对照组各50例,分别予以选择性痔上黏膜切除术及传统外剥内扎术治疗,观察两种术式治疗的术中情况、疗效和并发症情况。结果两组患者治疗后总有效率均为100%,差异无统计学意义(P>0.05);治疗组在术后疼痛、创面出血、肛缘水肿、尿潴留方面与对照组比较差异有统计学意义(P<0.05);住院时间、病人满意度、恢复正常工作等方面与对照组比较,差异有统计学意义(P<0.05)。结论选择性痔上黏膜切除术是治疗Ⅲ、Ⅳ度混合痔安全、有效的手术方式。

Objective To observe the clinical therapeutic effect of selective hemorrhoid mucosal resection in the treatment ofⅢ and Ⅳdegree mixed hemorrhoid. Methods One-hundred patients with III and IV degree mixed hemorrhoid were randomly divided into the treatment group or the control group, and were treated by selective hemorrhoid mucosal resection or traditional Milligan-Morgan operation. Intraoperative circumstance, therapeutic effect, and complication were observed and compared between the two groups. Results Both groups have an overall effective rate of 100%, with superiorities of the treatment group in postoperative pain, wound bleeding, anal edge edema, urine retention, hospital stay, patient satisfaction, and resuming to normal work （ all P 〈 0.05 ）. Conclusion Selective hemorrhoid mucosal resection is safe and effective in the treatment of stage ⅢandⅣ mixed hemorrhoid.