采用痔上黏膜环切吻合器治疗重度痔临床研究

Clinical study on procedure for prolapse and hemorrhoids （PPH） in treating hemorrhoids

目的 观察应用痔上黏膜环切术（PPH）治疗痔的临床效果.方法 Ⅱ、Ⅲ、Ⅳ度痔患者78例,均接受PPH治疗,记录诊断、病史、手术时间、出血量及围手术期并发症.手术前和手术后6h、24h、1个月采用世界卫生组织生活质量量表（WHOQOL-BREF）对患者进行评分.结果 术后疼痛视觉模拟评分（VAS）在6h评分为（7.6±2.1）分,术后24 h VAS评分减少至（1.3±1.1）分.术后并发症发生率较传统手术低（t=1.994,P=0.032）;术后生活质量总体评分、健康总体评分、身体状况和心理状况评分均显著改善（t=1.901、1.805、1.714,P=0.041、0.038、0.029,均P＜0.05）,环境评分有轻度改善,但差异无统计学意义（P＞0.05）,社会生活评分没有变化.结论 PPH手术取得良好的临床效果,并发症发生率低,患者生活质量得到提高,对于痔患者应作为推荐的首选手术方式.

Objective To observe the clinical effect of procedure for prolapse and hemorrhoids （PPH） in treating hemorrhoids.Methods 78 patients with symptomatic Ⅱ,Ⅲ and Ⅳ degree hemorrhoids undergoing PPH were selected in this study.The diagnosis,medical history,operative time,blood loss and perioperative complications were recorded.The World Health Organization Quality of Life Scale（WHOQOL-BREF） was observed preoperation and 6 hours,24 hours,1 month postoperation.Results The postoperative pain score measured by visual analogue scale （VAS） at postoperative six hours was （7.6 ± 2.1）,which reduced to （1.3 ± 1.1） at 24 hours.There was significant improvement in the overall perception of QOL,health,and in physical and psychological domains （t =1.901,1.805,1.714,P =0.041,0.038,0.029,all P ＜ 0.05）.There was modest improvement in environmental domain,while no change was found in social domain （P ＞ 0.05）.Conclusion PPH surgery achieves good clinical results,improved quality of life of patients,with a low incidence of complications,patients with hemorrhoids should be recommended for this preferred surgical approach.