环状混合痔皮瓣保留的探讨

Discussion on Retention of Annular Mixed Hemorrhoid Flap

目的集中探讨对环状混合痔的患者采用皮瓣保留术的临床效果。方法纳入2016年1月—2017年1月因患有环状混合痔于该院肛肠外科进行治疗的患者100例,按照随机分配的原则,其中50例接受传统外剥内扎治疗的患者为对照组,另50例接受改良外剥内扎保留皮瓣术的患者为观察组,比较两组患者的临床疗效、平均疗程及术后肛门狭窄、痔核残留和尿潴留等并发症情况。结果将两组患者的疗效进行比较,结果显示,观察组患者的治愈率98.0%明显高于对照组患者的86.0%,同时平均疗程(18.2±2.4)d也明显短于对照组患者(22.3±2.6)d,差异有统计学意义(P<0.05);观察组患者在肛门狭窄发生率(0.0%)、痔核残留发生率(0.0%)和尿潴留发生率(10.0%)明显低于对照组(2.0%)、(18.0%)、(26.0%),两组差异有统计学意义(P<0.01)。结论综上所述,对患有环状混合痔的患者采用皮瓣保留术在临床治疗中具有积极的意义,可对患处的痔核充分的处理,同时保留病灶周围组织及其器官的解剖结构和功能正常,可在临床中推广使用。

Objective This paper tries to investigate the clinical effect of flap retention in patients with annular mixed hemorrhoids.Methods 100 cases of patients with anorectal surgical treatment from January 2016 to January 2017 with circumferential mixed hemor-rhoid in this hospital were selected, according to the principle of random distribution, 50 patients who underwent conventional exter-nal strip treatment were regarded as the control group, the other 50 cases of modified external strip for internal firm retain skin flap were selected as the observation group, the clinical curative effect, average period of treatment and postoperative anal stricture, haem-orrhoids residues and complications such as urinary retention of the two groups of patients were compared. Results To compare the curative effect of two groups of patients, the results showed that the cure rate of 98.0% in the observation group, obviously higher than that of control group of 86.0%, at the same time, the average period of treatment was（18.2 ±2.4） d, also significantly shorter than the control group of（22.3±2.6） d, with statistically significant difference,（P〈0.05）; the incidence of anal stenosis in the observation group was 0.0%, the incidence of haemorrhoids residues was 0.0% and the incidence of urinary retention was 10.0%, significantly lower than the control group of 2.0%, 18.0%, 26.0%, two groups had significant statistical difference（P〈0.01）. Conclusion In summary, the clinical treatment of the use of flap retention in patients with annular mixed hemorrhoids has a positive significance; the suffering area of the hemorrhoids can be fully treated, while retaining the surrounding tissue and its organs anatomical structure can keep functional normal, which can be used in clinical practice.