RPH与PPH治疗内痔为主环状混合痔:附210例分析

RPH and PPH for Annular Mixed Hemorrhoid: 210 Cases Report

目的探讨RPH及PPH术治疗内痔为主环状混合痔的临床疗效。方法回顾我科2010年1月～2014年6月手术治疗的210例内痔为主环状混合痔患者临床资料,其中RPH组110例,PPH组共100例,分别行自动痔疮套扎术和吻合器痔上粘膜环切术。比较两组临床疗效及手术费用。结果两组患者均获得临床痊愈。组间比较,RPH组手术时间短,出血量少,手术费用低（P〈0.01）,而两组愈合时间比较无统计学差异（P〉0.05）。两组术后并发症比较,RPH组出血率低（P〈0.05）,术后疼痛及肛缘水肿、急便以及尿潴留率比较,均无统计学差异（P〉0.05）。术后1年随访,RPH组便血、痔核脱垂、急便感发生率均低于PPH组（P〈0.05）,肛门溢液率比较差异无统计学意义（P〉0.05）。结论 RPH和PPH均为微创术式,但RPH操作更简单,更容易临床推广,远期疗效更好。

Objective To analyze the effect and advantages,disadvantages of rubber band ligation procedure for prolapse and hemorrhoids（ RPH） and procedure for prolapse and hemorrhoids（ PPH） in the treatment of annular mixed hemorrhoid. Method A total of 210 cases with annular mixed hemorrhoid from January 2010 to June 2014 were analyzed retrospectively,including 110 of RPH（ PRH groups）,and 100 cases of PPH（ PPH groups）. Results All 210 cases were obtained clinical healing. Compare to PPH group,the operative time was shorter（ P〈0. 01）,blood loss was less（ P〈0. 01）,surgical cost was lower（ P〈0. 01）,post-operative hemorrhage rate was lower（ P〈0. 05） in RPH group,there was no statistical difference in healing time,post-operative pain and crissal edema between two groups（ P〉0. 05）. After 1 year follow-up,the long-term efficacy of hemafecia,hemorrhoid prolapse and sensation of fecal urgency was better in RPH group than those in PPH group（ P〈0. 05）. Conclusions Both RPH and PPH are effective micro-invasive surgery for annular mixed hemorrhoid. Nevertheless,RPH is simpler in operating,better in long-term effect,and easier to be popularized.