RPH联合外剥内扎术治疗混合痔的临床疗效观察

Clinical observation on mixed hemorrhoids treated by Ruiyun Procedure for Hemorrhoids and external dissection and internal ligation procedure

目的 观察直肠粘膜套扎吻合术（Ruiyun Procedure for Hemorrhoids,RPH）联合外剥内扎术治疗混合痔的临床疗效。方法 将704例需手术治疗的Ⅱ~Ⅳ度混合痔患者按入院号单双号将其随机分为联合组350例和传统组354例,联合组采用RPH联合外剥内扎术治疗,传统组采用单纯外剥内扎术治疗。对比两组患者的疗效、创面愈合时间、术后24h疼痛程度、肛门坠胀时间及并发症（如术后尿储留、术后脱落期出血、创面水肿、肛门狭窄）情况。结果 联合组总有效率99.71%,高于传统组的98.59%,但两组间差异无统计学意义（P〉0.05）;联合组术后创面愈合时间、术后24h疼痛程度及肛门坠胀时间均低于传统组,两组间差异均有统计学意义（均P〈0.05）;联合组术后尿储留、术后脱落期出血、创面水肿、肛门狭窄等相关并发症均少于传统组,差异均有统计学意义（均P〈0.05）。结论 RPH术联合外剥内扎术治疗混合痔疗效可靠,术后并发症少,创面愈合快,可在临床推广应用。

Objective To explore the clinical effect of mixed hemorrhoids treated by Ruiyun Procedure for Hemorrhoids （RPH） and external dissection and internal ligation procedure. Methods 704 patients with Ⅱ-Ⅳ mixed hemorrhoids requiring surgery were randomly divided into mixed treatment group and conventional treatment group according to the hospitalization number. The mixed treatment group was treated by RPH and external dissection and internal ligation procedure. The conventional treatment group was treated by external dissection and internal ligation procedure. The efficacy, wound healing time, postoperative 24h pain, anal swelling time and complications such as postoperative urinary retention, postoperative bleeding, wound edema, anal stenosls of the two groups were compared. Results The total effective rate of mixed treatment group was 99.71%, which was higher than that of the conventional treatment group（P〈 0. 05）. The postoperative wound healing time, postoperative 24h pain and anal fall time of mixed treatment group were lower than that in the conventional treatment group（P〈0.05）. Postoperative urinary retention, postoperative bleeding during shedding stage, wound edema and anal stenosis in the mixed treatment group were less than those in the conventional treatment group（P〈0.05）. The difference was statistically significant. Conclusion RPH mixed with external dissection and internal ligation procedure are effective and reliable in treatment of mixed hemorrhoids with few complications and fast wound healing.