改良PPH术结合外痔切除治疗重度混合痔手术观察

Observation of modified PPH combined with external hemorrhoidectomy in the treatment of severe mixed hemorrhoid

目的探讨改良吻合器痔上黏膜环切术(PPH术)结合外痔切除治疗重度混合痔的手术效果及安全性。方法 150例内痔为Ⅱ、Ⅲ、Ⅳ度的重度混合痔患者,随机分为改良PPH术组(75例)和常规组(75例),分别行改良PPH术+外痔切除和"外剥内扎"法,观察两组手术效果及术后安全性。结果改良PPH术组治疗总有效率为97.3%,明显高于常规组的82.7%,差异具有统计学意义(P<0.05)。改良PPH术组安全度为100.0%,明显高于对常规组的80.0%,差异具有统计学意义(P<0.05)。结论改良PPH术治疗重度混合痔效果明确,安全性高,值得与外痔切除术联合使用并在临床中推广使用。

Objective To investigate operation effect and safety by modified procedure for prolapse and hemorrhoids（PPH） combined with external hemorrhoidectomy in the treatment of severe mixed hemorrhoid. Methods A total of 150 severe mixed hemorrhoid patients with degree Ⅱ, Ⅲ and Ⅳ internal hemorrhoids were randomly divided into modified PPH group（75 cases） and conventional group（75 cases）, and they respectively received modified PPH ＋ external hemorrhoidectomy and Milligan-Morgan operation. Observation was made on operation effects and postoperative safety in both groups. Results Modified PPH group had obviously higher total effective rate in treatment as 97.3% than 82.7% in the conventional group, and their difference had statistical significance（P〈0.05）. Modified PPH group had much higher degree of safety as 100.0% than 80.0% in the conventional group, and the difference had statistical significance（P〈0.05）. Conclusion Modified PPH shows excellent effect in treating severe mixed hemorrhoid, along with high safety. This method in combination with external hemorrhoidectomy is worth clinical promotion and application.