双重PPH对治疗重度痔病的疗效观察

Clinical effect of twice procedure for prolapse and hemorrhoids in Treating Severe Hemorrhoid

目的探讨双重PPH治疗重度痔的临床疗效。方法对200例Ⅲ、Ⅳ度痔病患者,采用国产可重复使用痔吻合器分别行常规PPH及双重PPH,观察并比较两组患者手术时间、肛垫上移率、切除痔上黏膜宽度、肛缘水肿时间、术后出血、术后疼痛率、住院天数、住院费用及随访半年后复发情况。结果两组患者手术时间分别是21.89min和35.47min,两组肛垫上移率、切除痔上黏膜宽度及随访半年后复发情况差异有统计学意义(P<0.05),双重PPH组效果明显优于常规PPH组;而肛缘水肿时间、术后出血量及术后疼痛率则差异无统计学意义(P>0.05);住院天数和住院费用并未明显增加。结论双重PPH较常规PPH具有更好的效果,围手术期并发症并未明显增加,而国产可重复使用痔吻合器具有价格便宜、可重复利用等优势,使双重PPH可在基层医院中推广使用。

Objective To explore the clinical effect of regular and twice procedure for prolapse and hemor- rhoids （PPH） in treating severe hemorrhoid. Methods Two hundred cases of Ⅲ Ⅳdegree prolapsed hem- orrhoids were treated by regular and twice PPH, respectively. The operation time, cushions move rate, mucosa width, edema of anal edge, postoperative bleeding, postoperative pain, hospitalization days, the medical expense and recurrence after six months were observed and recorded. Results The operation lasted for an average 21.89 mins and 35.47minutes, respectively. There were statistical significant differences between two groups in anal cushions move rate, mucosa width, postoperative pain and recurrence after six months （ P 〈0.05}. There were no statistical significant difference between two groups in edema of anal edge, postoperative bleeding and postoperative pain （ P 〉0. 05）. No evidence showed that twice PPH would significantly increase the hospitalization days and the medical expense. Conclusion Twice PPH have better clinical effect than regular PPH in treating severe hemorrhoid with the similar perioperative compli- cations. Twice PPH could be promoted in basic hospital with cheaper and repeat-used domestic stapler.