高频电刀对混合痔外剥内扎切口愈合的影响

The Effect on the Wound Healing of Milligan-Morgan Hemorrhoidectomy with High Frequency Electric Knife for Mixed Hemorrhoids

目的观察混合痔外剥内扎手术中应用高频电刀对创面愈合的影响。方法选取60例肛缘有三个大小均匀、相互孤立的混合痔患者,采用混合痔外剥内扎手术,每位患者三个外痔处理分别采用高频电刀外痔切除剥离、手术剪外痔剥离电凝止血、手术剪外痔剥离压近或可吸收线缝扎止血,应用自体对照进行对比观察。结果三组创面手术时间、术中出血量比较差异有统计学意义(P<0.05),但切口愈合时间比较,差异均无统计学意义(P>0.05)。术后所有患者随访1~2个月,至创面完全愈合。三组术后切口感染率、皮瓣坏死率及创面愈合后平整度比较,差异均无统计学意义(P>0.05)。结论在混合痔外剥内扎手术中,正确合理应用高频电刀进行组织切割及电凝止血对切口愈合没有明显的影响,同时能够降低手术操作难度,减少术中出血,缩短手术时间,值得临床推广应用。

Objective To observe the clinical effect of high frequency electric knife on the wound healing of Milligan-Morgan hemorrhoidectomy for treating mixed hemorrhoids. Methods Sixty cases of mixed hemorrhoids with uniform size and isolated from the anal verge were selected and performed Milligan-Morgan hemorrhoidectomy. Self-control study was taken on： three external hemorrhoids of each patient were dissected respectively by using high-frequency electric knife,scissors stripping and electric coagulation and scissors external dissection and hemostasis of compression and absorption line transfixion,and were regarded as electric knife group,electric coagulation group and control group respectively. Results There were statistical differences in the operative duration and intra-operative blood loss（P〈0.05）,but not in wound healing duration among three groups（P〈0.05）. All cases were followed up for one to two months. No statistical difference was found in post-operative infection rate,skin flap necrosis rate and wound roughness rate among three groups（P〈0.05）.Conclusion In the Milligan-Morgan hemorrhoidectomy,the correct and reasonable application of high frequency electric knife for tissue cutting and coagulation has no obvious adverse effect on wound healing,it can reduce the difficulty of operation,decrease the intra-operative bleeding loss and shorten the operation time,and it is worthy of clinical generalization.