痔上黏膜缝扎结合外剥(切)内“回”字结扎治疗混合痔的临床应用

Clinical application of hemorrhoidal mucosa transfixion combined with external dissection (cut) and internal “hui” ligature treating mixed hemorrhoids

目的比较痔上黏膜缝扎结合外剥(切)内"回"字结扎术、吻合器痔上黏膜环切术(PPH)、外剥内扎术治疗混合痔的效果。方法选取2015年11月~2016年12月在赣州市立医院肛肠科住院手术的90例混合痔患者作为研究对象,随机分为治疗组和对照A组、对照B组,每组30例。治疗组采用痔上黏膜缝扎结合外剥(切)内"回"字结扎术,对照A组采用PPH术,对照B组采用外剥内扎术。观察三组的手术时间、术中出血量、住院天数、住院费用及并发症发生情况等。结果治疗组的住院天数、住院费用、术中出血量均低于对照A组、对照B组,差异有统计学意义(P<0.05);三组的手术时间差异无统计学意义(P>0.05);三组患者在术后7 d的出血情况差异有统计学意义(Z=-4.128,P<0.01);三组患者在术后各时间点的脱垂情况比较,差异无统计学意义(P>0.05)。结论痔上黏膜缝扎结合外剥(切)内"回"字结扎治疗混合痔的效果理想,值得推广应用。

Objective To compare the clinical effect of hemorrhoidal mucosa transfixion combined with external dissection （cut） and internal ＂hui＂ ligature,procedure for prolapse and hemorrhoids （PPH） and milligan-morgan hemorrhoideetomy trerating mixed hemorrhoids.Methods Ninety hospitalized patients with mixed hemorrhoids in Department of Anoreetum, Ganzhou Municipal Hospital from November 2015 to December 2016 were selected as objects and they were randomly divided into treatment group,control group A and control group B and there were 30 cases in each group. Treatment group was given hemorrhoidal mucosa transfixion combined with external dissection （cut） and internal ＂hui＂ ligature,control group A was given PPH operation,while control group B was given milligan-morgan hemorrhoidectomy.The operation time,intraoperative blood loss,hospital stay,hospitalization cost and incidence of complication in two groups were observed.Results The hospital stay,the hospitalization cost and intraoperative blood loss in treatment group were significantly lower than those in control group A and control group B,and there was a statistical difference （P〈0.O5）,and there was no significant difference of the operation time among the three groups （P〉0.05）.The difference of bleeding among the three groups after 7 d operation was statistically significant （Z=-4.128,P〈0.01）.There was no significant difference of prolapse among the three groups at each time point after operation （P〉0.05）.Conclusion Hemorrhoidal mucosa transfix- ion combined with external dissection （cut） and internal ＂hui＂ ligature treating mixed hemorrhoids has a ideal effect and it is worthy of promotion and application.