内痔结扎外痔切除一期缝合术治疗混合痔50例临床观察

Clinical observation on 50 cases of internal hemorrhoid ligation external hemorrhoids resection primary suture in the treatment of mixed hemorrhoids

目的比较内痔结扎外痔切除一期缝合术和传统Milligan-Morgan术的疗效及术后疼痛、水肿、出血等情况。方法将2015年1月~2016年12月就诊于我院肛肠外科的100例混合痔患者招募入组。随机将患者分为两组,试验组50例采用内痔结扎外痔切除一期缝合术,对照组50例采用传统Milligan-Morgan术。观察两组切口愈合时间、术后疼痛、水肿、出血等情况。结果试验组与对照组治愈率比较无显著差异(96%vs 94%,P>0.05)。试验组术后24 h(3.95±1.24 vs 5.85±1.56,P<0.05)、第一次排便时(5.85±1.66 vs 7.75±1.68,P<0.05)及术后第7天(2.45±1.09 vs 4.35±1.26,P<0.05)疼痛评分均显著低于对照组。试验组创面愈合时间(11.95±1.96 vs 17.85±2.35,P<0.05)、术后出血积分(1.05±0.31 vs 1.87±0.65,P<0.05)及术后水肿积分(0.58±0.22 vs 1.24±0.26,P<0.05)均显著低于对照组。结论与传统Milligan-Morgan术相比,内痔结扎外痔切除一期缝合术疗效肯定,愈合时间短,疼痛轻,术后并发症少。

Objective To compare the efficacy and postoperative pain, edema and hemorrhage between internal hemorrhoid ligation external hemorrhoids resection primary suture and traditional Milligan-Morgan technique. Methods A total of 100 patients with mixed hemorrhoids in Department of Anorectal Surgery of our hospital from January 2015 to December 2016 were enrolled. These patients were randomly divided into two groups. 50 patients in the experimental group were treated with internal hemorrhoid ligation and external hemorrhoids resection primary suture. 50 patients in the control group were treated with traditional Milligan-Morgan technique. The wound healing time, postoperative pain,edema and bleeding of the two groups were observed. Results There was no significant difference in the cure rate between the experimental group and the control group（96% vs 94%, P〉0.05）. The pain score of the experimental group was significantly lower than that in the control group at 24 hours after surgery（3.95±1.24 vs 5.85±1.56,P〈0.05）, at the first time of defecation（5.85±1.66 vs 7.75±1.68,P〈0.05）, on the 7th day after surgery（2.45±1.09 vs 4.35±1.26,P〈0.05）.Similar ly, the wound healing time, postoperative bleeding score and postoperative edema score in the experimental group were significantly lower than those in the control group（11.95±1.96 vs 17.85±2.35, P〈0.05）,（1.05±0.31 vs 1.87±0.65, P〈0.05）,（0.58±0.22 vs 1.24±0.26, P〈0.05）,respectively. Conclusion Compared with the traditional Milligan-Morgan technique, the treatment of internal hemorrhoid ligation external hemorrhoids resection primary suture has positive effect, with short healing time, mild pain and few postoperative complications.