不同手术方式治疗重度痔的效果及对患者排便功能的影响

The Clinical Effects on Different Surgical Treatments for the Severe Hemorrhoids Patients

目的探究不同手术方式对重度痔患者术后并发症及排便功能的影响。方法选取2011年1月至2013年12月来我院就诊的重度痔患者216例,随机分为治疗组和对照组,每组108例。治疗组予以吻合器痔上粘膜环切术(proceduce for prolapse and hemorrhoids,PPH)进行治疗,对照组予以常规外剥内扎法进行治疗。结果治疗组患者手术时间(31.54±8.34)min,术中出血量(23.14±8.24)ml,创口愈合时间(10.64±3.76)d,术后仅1例(0.93%)发生切口感染,均明显优于对照组,对照组的手术时间为(47.22±11.05)min,术中出血量(38.17±13.52)ml,创口愈合时间(21.80±3.95)d,术后24 h尿潴留率5.56%(6/108)、排便困难发生率3.70%(4/108)及切口感染率6.48%(7/108)(P<0.05);治疗组的总有效率明显高于对照组(P<0.05)。结论 PPH治疗重度痔效果明显优于常规外剥内扎治疗法,可明显降低患者术后并发症及排便困难的发生。

Objective To explore the clinical effects on different surgical treatment for the severe hemorrhoids patients. Methods 216 cases of severe hemorrhoids who came to our hospital from January 2011 to December 2013 were enrolled. The patients were divided into treatment group and control group according to the prospective study methods, with 108 eases in each group. The patients of treatmeni group were taken procedure for prolapse and hemorrhoids （PPH） for treatment, and the control group received the Milligan-Morgan methods. Results The operative time was （ 31.54 ± 8.34 ） min, blood loss was （23.14 ± 8.24 ） ml , wound healing time was（ 10.64 ± 3.76）d in the treatment group, which was significantly lower than the operative time of （47.22 ± 11.05 ）min, blood loss of （38.17 ± 13.52 ）ml and wound healing time of（ 21.80 ±3.95 ）d of the control group（ P 〈 0.05 ）. The complication rate was also significantly lower in the treatment group, with 24h urinary retention rate 0 vs. 5.56%, difficult defecation rate 0 vs. 3.70%, and wound infection rate 0.93% vs. 6.48% （P 〈0.05）. The total efficiency rate of the treatment group was significantly higher than the control group （P 〈 0.05 ）, which was 99.07% vs. 93.52%. Conclusion PPH for severe hemorrhoids is better than the conventional Milligan-Morgan methods with the significantly reduction of the postoperative complications.