PPH结合改良外剥内扎注射术治疗环状混合痔疗效观察

Clinical Observation on the Therapeutic Effect of the Modified PPH Combined with External Dissection and Internal Ligationand Injection for Circumferential Mixed Hemorrhoids

目的探讨PPH结合改良外剥内扎注射术治疗环状混合痔的疗效。方法将600例环状混合痔随机分为对照组、PPH组和治疗组,每组200例。对照组采用外剥内扎术治疗,PPH组采用PPH治疗,治疗组采用PPH结合改良外剥内扎注射术(保留齿线分段缝扎和局部黏膜下注射消痔灵液)治疗,观察三组患者手术后的一般情况,比较术后并发症。结果三组患者均治愈,在术后出血、肛门狭窄、术后肛缘水肿方面比较差异无统计学意义(P>0.05)。PPH组在手术时间、术后24h疼痛评分方面与其余两组比较具有统计学意义(P<0.05);PPH组与治疗组在术后3d、7d疼痛评分、恢复工作时间方面比较差异无统计学意义(P>0.05),而与对照组比较具有统计学意义(P<0.05);治疗组与对照组、PPH组在患者满意度方面差异具有统计学意义(P<0.05)。结论 PPH结合改良外剥内扎注射术治疗环状混合痔其创伤小于外剥内扎术,术后疼痛明显优于外剥内扎术。该法可降低PPH术后的复发率和并发症发生率,减轻患者术后不适,提高患者的满意度。

Objective To investigate and analyze the clinical efficacy of the modified PPH combined with external dissection and internal ligation and injection for circumferential mixed hemorrhoids.Methods Six hundred case of circunmferential mixed hemorrhoids were randomized into control group,PPH group and treatment group,with 200 cases for each group.The control group underwent exernal dissection and internal ligation,the PPH group received PPH,and the treatment group treated by modified PPH combined with external dissection and internal ligation and injection.All the three groups were observed for their general condition after surgery and compared for postoperative complications.Results The results showed that all the patients in three groups got cured,which showed no significant difference in bleeding case,anal stenosis and analedge edema （P〉0.05）.PPH group was significantly different from the other two groups in operation time and pain scores 24h after operation （P〈0.05）.No significant difference was observed between any pair of PPH group and treatment group in pain scores 3d and 7d after operation,and time for returning to work （P〉0.05）,but they were singnificantly different from the controls （P〈0. 05）.Significant difference was found among PPH group,control group and treatment group in patient’s satisfaction （P〈0.05）.Conclusion It could be concluded that the modified PPH combined with external dissection and internal ligation and injection is less invasive and superior to simple external dissection and internal ligation in postoperative pain.The surgical procedure could be lower the recurrence rate and incidence of complications of PPH,reduce postoperative discomfort of patient and improve patient’s satisfaction.