选择性痔上黏膜切除钉合术与混合痔外剥内扎术联合术式治疗78例环形脱出混合痔临床疗效观察

目的：观察和评价选择性痔上黏膜切除钉合术（TST）与传统混合痔外剥内扎术联合术式治疗重度环形脱出痔病的临床疗效,以期提供可靠的治疗依据.方法：选取我院2013年1月至2014年6月间在肛肠科住院的156例重度脱出的混合痔患者,随机分为TST＋传统手术联合术组和单纯传统手术组,每组各78例痔病患者,对照组患者采取单纯的混合痔外剥内扎术,治疗组患者采取TST＋混合痔外剥内扎术联合术式.两组患者肛门伤口疼痛情况、治愈率及术后创面的修复生长情况、创面愈合时间进行对比.结果：两组临床疗效比较,差异有统计学意义.治疗组在术后肛门疼痛感、平均创面愈合时间及修复生长情况明显优于传统手术组（P〈0.05）.结论：联合术式对重度脱出混合痔患者的治疗效果是肯定的,较单纯传统手术优势明显,对肛门功能损伤小,术后尿潴留发生率低,肛门坠胀疼痛感轻,住院时间短,值得在临床推广应用.

Objective ：To compare the clinical effect of Selective nail procedure for prolapse and hemorrhoids mucosa resection （TST） combined with manually invasive operation of traditional processing and traditional external dissection and internal ligation surgery in the treatment of circumferential mixed hemorrhoids, to investigate the reliable method of clinical effective treatment of circumferential mixed hemorrhoids, so as to provide reference, basis for the clinical treatment of circumferential mixed hemorrhoids and the related research.Methords：156 patients with circumferential mixed hemorrhoids treated in our hospital from January 2013 to June 2014 were selected as the study objects,and they were randomly divided into the TST ＋ operation group （n=78） and traditional operation group （n=78）,they were respectively given the TST combined with minimally invasive operation of manual processing and traditional external dissection internal ligation surgery, the clinical curative effect, the hospitalization time and cost in the two groups were compared.Results：The treatment effect in the TST operation group was better than the traditional operation group. And there was a statistical difference in the two groups. The average wound healing time and anal pain were shorter than the traditional operation group. Conclusion： Combined operation for patients with severe mixed hemorrhoid prolapse were positive. Anal function damage in TST group is small, and low incidence of postoperative urinary retention, anal belly pain is light, short duration, no anastomotic stenosis occurred.