痔上黏膜环切术与外剥内扎术Ⅰ期治疗急性嵌顿痔的对比观察

Comparison of Procedure for Prolapse and Hemorrhoids with Milligan-morgan Hemorrhoideetomy for Acute Incarcerated Hemorrhoid in the Stage I Treatment

目的比较痔上黏膜环切术(PPH)与外剥内扎术(MMH)I期治疗急性嵌顿痔的疗效。方法对82例急性嵌顿痔I期手术治疗患者的临床资料进行回顾性分析。根据手术方式不同,分为传统术式MMH组(36例)和新近术式PPH组(46例)。对2组患者手术时间、术后视觉模拟评分(VAS)、注射止痛药次数、术后出血、尿潴留、肛缘水肿、肛门坠胀感、住院时间及住院费用等方面进行比较。结果手术后,2组患者的症状均缓解。PPH组住院费用[(10 453±1 246)元]多于MMH组[(6 564±1 023)元],差异有统计学意义(P<0.05);PPH组术后24 h和第1次排便VAS评分{[(4.53±0.83)分]、[(4.89±0.62)分]}低于MMH组{[(6.58±0.87)分]、[(6.43±0.77)分]},差异有统计学意义(P<0.05);PPH组术后使用止痛药次数[(1.53±0.88)次]低于MMH组[(2.46±0.94)次],差异有统计学意义(P<0.05);PPH组住院时间[(7.94±1.22)d]低于MMH组[(12.30±2.51)d],差异有统计学意义(P<0.05);PPH组术后出血、肛缘水肿、尿潴留例数(2、3、33例)低于MMH组(7、11、4例),差异有统计学意义(P<0.05)。结论 PPH I期治疗急性嵌顿痔安全、有效,疗效优于传统MMH。

Objective To compare the efficacy of procedure for prolapse and hemorrhoids （PPH） and milligan-morgan hemorrhoidectomy （MMH） stage I for treatment of acute incarcerated hemorrhoid. Methods 82 cases of acute incarcerated hemorrhoid stage I surgery for the treatment of patients with clinical data were retrospectively analyzed. All patients were di- vided into PPH group （n = 46 ） and MMH group （n = 36） according to the different ways of operation to compare the opera- tion time, postoperative VAS score postoperative bleeding, injection of the painkiller times, urinary retention and edema of a- nal edge ,the anus sank bilge feeling,length of hospital stay ,and hospitalization expenses in 2 groups of patients. Results The symptoms of patients in both group were relieved after surgery. Although PPH group of patients in hospital cost more than the MMH group of patients （P 〈 0.05 ） , but in the postoperative VAS score, number of injection of the painkiller, edema of anal edge, etc. on the incidence of complications,length of hospital stay were significantly superior to MMH group （P 〈 0.05 ）. Conclusion Stage I PPH for the treatment of acute incarcerated hemorrhoids is safe, effective, and superior to the traditional MMH.