改良PPH术治疗环状脱垂痔的临床效果观察

Effects of improved PPH surgery on circular prolapsed hemorrhoids

目的观察改良吻合器痔上黏膜环切术(PPH)治疗环状脱垂痔的临床效果,以期为环状脱垂痔的治疗提供借鉴。方法选取我院收治的环状脱垂痔患者120例,随机分为改良组和传统组,传统组予传统PPH术治疗,改良组予改良PPH术治疗,技术改进主要包括降低荷包缝合平面,双半荷包缝合,观察比较两组手术疗效及预后。结果改良组的有效率为90.32%,明显高于传统组的70.69%(P<0.05);改良组的术中出血量、术后出血、尿潴留、肛缘水肿、住院时间以及术后复发率均明显低于传统组(P<0.05)。结论改良PPH术治疗环状脱垂痔疗效较好,值得推广,但在应用时要严格掌握手术适应证,注意操作细节,以保证手术效果。

Objective To observe the effects of improved procedures for prolapse and hemorrhoids （PPH） surgery on circular prolapsed hemorrhoids to provide reference for the treatment of prolapsed circumferential hemorrhoids. Methods A total of 120 patients with prolapsed circumferential hemorrhoids admitted to our hospital were selected and randomly divided into an improved group and a traditional group. The traditional group was treated with traditional PPH surgery and the improved group with improved PPH surgery. The technical improvement mainly includes the reduction of purse-string suture plane and the adoption of double half purse-string suture to observe and compare the effects of surgical treatment and the prognosis in the two groups, Results The RR in the improved group was 90.23%, which was much higher than that in the tradition group（70.69%）（P 〈 0.05）; the intraoperative amount of bleeding, the incidence of postoperative bleeding, urinary retention, anal edema, LOS and postoperative recurrence rate in the improved group were much lower or shorter than those in the traditional group（P 〈 0.05）. Conclusion The improved PPH surgery has good effects on the treatment of prolapsed circumferential hemorrhoids and is worthy of popularization. However, surgical indications should be strictly followed and operational details should be focused on in order to ensure the effect of surgery.