外剥内缝扎术悬吊联合皮桥整形在环状混合痔中的应用体会

The application experience of the Outside the strip inner suture suspension combined with skin bridge forming in circumferential mixed hemorrhoids

目的探讨外剥内缝扎悬吊术联合皮桥成形在环状混合痔中的应用价值。方法将650例环状混合痔患者随机分为治疗组(332例)和对照组(328例),治疗组行外剥内缝扎悬吊术联合皮桥成形,对照组行外剥内扎术,对比观察两组疗效、术后并发症、术后肛门功能、平均住院时间及创面愈合时间。结果两组治愈率、好转率、术后大出血、术后疼痛对比无统计学差异(P>0.05);治疗组在术后肛门功能、肛门狭窄、水肿、赘皮残留、平均住院时间及创面愈合时间均优于对照组,有统计学差异(P<0.05)。结论外剥内缝扎悬吊术联合皮桥成形治疗环状混合痔在保护肛门功能、减少术后并发症及缩短治疗周期等方面优于传统的外剥内扎术,值得推广应用。

Objective To explore the application value of the outer strip suture suspension combined with skin bridge formation in the circular mixed hemorrhoids.Methods Six hundred and fifty cases of annular mixed hemorrhoid were randomly divided into treatment group （N=332）and matched group （N=328）. The patients in treatment group were perforemed outside the strip inner suture suspension combined with skin bridge forming,and the matched group were perforemed the Milligan Morgan hemorrhoidectomy. The curative effect,postoperative complications,anal function,average time of stay in hospital and wound healing time were compared between two groups.Results There are no significant difference in the cure rate,improvement rate and postoperative bleeding between the two groups （P〉0.05）.The postoperative anal function,anal stenosis,edema,epicanthus residue,the average hospitalization time and wound healing time in the treatment group were better than the matched group,and there were statistically significant difference （P〈0.05）.Conclusion Stripping internal suture suspension combined with skin bridge formation in treatment of circumferential mixed hemorrhoids in the protection of anal function,reduce postoperative complications and shorten the treatment cycle is superior to Milligan,and it is worthy of popularization and application.