PPH加肛瘘切除术治疗合并肛瘘的重度痔疮临床疗效观察

Efficacy of PPH combined with fistulectomy in treatment of severe hemorrhoids complicated with anal fistula

目的探讨吻合器痔上黏膜环切术加肛瘘切除术治疗重度混合痔合并肛瘘的临床疗效。方法将60例混合痔合并肛瘘患者随机分成吻合器痔上黏膜环切术加肛瘘切除术组(观察组)和外剥内扎加肛瘘切除术组(对照组),每组30例。观察和比较2组手术时间、住院时间、术中出血量、术后出血、尿潴留、肛门坠胀及水肿、术后疼痛时间、术后控便能力下降、感染、术后复发等情况。结果观察组手术时间、术中出血量、术后出血、术后疼痛时间、术后控便能力下降、肛门坠胀及水肿、住院时间优于对照组,差异有统计学意义(P值均小于0.05);2组在尿潴留、感染、肛瘘复发等方面的差异均无统计学意义(P值均大于0.05)。结论 PPH加肛瘘切除术治疗重度痔疮合并单纯性肛瘘是安全可行的术式。

Objective To explore the efficacy of the procedure for prolapse and hemorrhoids （ PPH） combined with fistu-lectomy in treatment of severe hemorrhoids complicated with anal fistula .Methods 60 patients with severe hemorrhoids com-plicated with anal fistula admitted for surgical treatment were randomly divided into a PPH plus fistulectomy group （ investiga-tion group ） and a milligan-morgan plus fistulectomy group （ control group ） ,30 cases for each .The two groups were observed and compared in terms of operating time,hospitalization time,intraoperative blood loss,postoperative bleeding,urinary reten-tion,anus belly,postoperative pain time and the ability of controlling feces ,infection,postoperative recurrence ,and so on.Re-sults There were no significant differences between the 2 groups in urinary retention ,infection,and postoperative recurrence （ P〉0.05 ） .The investigation group was superior to the control group in operating time , hospitalization time , intraoperative blood loss,postoperative bleeding,anus belly,postoperative pain time and the ability of controlling feces （P〈0.05）.Conclu-sion The treatment of severe hemorrhoids complicated with simple anal fistula with PPH plus anal fistula resection is safe and feasible.