吻合器痔上黏膜环切术(PPH)治疗重度痔术后并发症分析(附384例报告)

Postoperative complications of severe hemorrhoids treated with PPH : experience of 384 cases

目的探讨PPH术后并发症的原因及防治体会。方法回顾性分析2011—01-2013—12间实施PPH术治疗的384例重度痔患者术后并发症的情况。结果尿潴留81例（21．1％），肛门疼痛需用止痛剂165例（42．9％），术后原发性出血4例（1．1％），术后继发性出血7例（1．8％），肛门残留皮赘或仍有轻度痔核脱垂18例（4．7％），肛门狭窄2例（O．5％），直肠阴道瘘1例。随访1030个月，有2例再次人院行痔切除术。结论PPH术虽具有操作简便，创伤小、恢复快等优点，但仍需进一步规范手术操作及围手术期处理，减少并发症发生。

Objective To explore the risk factors and prevention measure about complications of laparoscopic cholecystectomy post- operative. Methods Retrospective analysis of clinical data of 293 patients who were treated with laparoscopic cholecystectomy in our hospi- tal, with high risk factors of complications, detailed analysis of laparoscopic eholecystectomy after operation, explored prevention strategy. Results 293 cases operation were successful, the average operation time was （39. 56 ± 5.47 ） min, the mean hospitalization time was （7. 56 ±1.73 ） d, and no conversion to open operation cases, including 19 eases of bile duct injury, 4 cases of bile leakage, 6 cases of infec- tion, 1 case of hemorrhage, 2 cases of intestinal obstruction or visceral injury and stab hernia the complication rate was 10. 92%. Bile duct in- jury, alanine transaminase enzyme levels, age, whether use somatostatin had no obvious relevance （P 〉 0. 05 ）, and total bilirubin had correla- tion with serum albumin level （ P 〈 0. 05 ）. Conclusion The occurrence of complications in laparoscopic cholecystectomy patients has closely related to patients＇ own characteristics, must strengthen the normative operation in surgery process, implementation of preventive measures which can ensure operation effect, reduce the incidence of postoperative complications.