吻合器痔上黏膜环切术联合外痔切除术治疗混合痔的临床疗效

The clinical curative effect of PPH combined haemorrhoidectomy in the treatment of mixed hemorrhoids

目的:探讨吻合器痔上黏膜环切术(PPH)联合外痔切除术治疗混合痔的临床疗效。方法:选择2013年10月至2016年4月温州市龙湾区第一人民医院收治的94例混合痔患者,其中治疗组46例,对照组48例;治疗组采用PPH联合外痔切除手术治疗,对照组采用传统的外剥内扎手术治疗;对比分析2组患者在手术时间、术中出血量、术后创面大出血、术后排便困难、术后留置尿管天数、术后肛门部疼痛评分、治疗总费用及出院后随访复发情况等方面的差异。结果:2组患者全部痊愈出院,虽然对照组在手术时间、术后留置尿管天数及治疗总费用方面优于治疗组(P<0.05),但在术中出血量、术后创面大出血、术后排便困难、术后肛门部疼痛评分及出院后随访复发情况等方面均劣于治疗组(P<0.05)。结论:PPH联合外痔切除手术治疗混合痔的疗效及安全性高于传统的混合痔外剥内扎手术治疗方法。

Objective： To explore the clinical curative effect of patients with mixed hemorrhoids who underwent the surgical treatment of procedure for prolapsed and hemorihoids（PPH） combined haemorrhoidectomy. Methods： Ninety-four patients with mixed hemorrhoid from Wenzhou Longwan First People＇s Hospital in October 2013 to April 2016 were included. All of the 94 patients with mixed hemorrhoid were divided into treatment group（46 cases） and control group（48 cases）. The treatment group underwent PPH combined haemorrhoidectomy, while the control group underwent Milligan-Morgan. Then the operation duration, intraoperative blood loss, postoperative wound bleeding, postoperative defecate difficulty, postoperative days of indwelling a urinary catheter, the postoperative pain scores of the anus, hospitalization cost and the follow-up of relapse, etc. were compared between two groups. Results： Two groups of patients all were discharged from hospital. Although in the operation time, postoperative days of indwelling a urinary catheter and hospitalization cost of treatment group were inferior to that in control group（P0.05）, but the intraoperative blood loss, postoperative wound bleeding, postoperative defecate difficulty, the postoperative pain scores of the anus and the follow-up of relapse, etc. of treatment group were superior to that in control group（P0.05）. Conclusion： The clinical effect and security of PPH combined haemorrhoidectomy is more higher than that of conventional surgical treatment in mixed hemorrhoids.