直肠黏膜悬吊外剥内扎术与Milligan-Morgan术治疗混合痔的对比研究

A Comparative Study of Mixed Hemorrhoids Treated by the Rectal Mucosa Ligated with Milligan-Morgan or Milligan-Morgan

目的:对比直肠黏膜悬吊外剥内扎术与Milligan-Morgan术治疗混合痔的疗效和并发症。方法:将86例混合痔患者随机分为观察组(直肠黏膜悬吊外剥内扎术组)和对照组(Milligan-Morgan术组),每组43例,观察并比较两组临床疗效、手术时间、术中出血量、肛缘水肿、术后疼痛、术后住院时间以及切口愈合时间的差异。结果:观察组治愈40例,好转3例;对照组治愈39例,好转4例;两组疗效比较差别无统计学意义(P>0.05)。观察组手术用时(41.8±9.2)min,对照组为(35.4±10.3)min,两组比较差异有统计学意义(P<0.05)。观察组术中出血量(38.4±7.0)ml,对照组为(35.6±9.0)ml,两组间比较差异无统计学意义(P>0.05)。观察组术后疼痛评分(5.3±0.8)分,显著低于对照组的(6.7±1.2)分,差异有统计学意义(P<0.05)。观察组肛缘水肿评分(0.9±0.8)分,显著低于对照组的(1.5±0.9)分,差异有统计学意义(P<0.05)。观察组术后住院时间(7.8±1.7)d,对照组为(8.3±2.0)d,两组间比较差异无统计学意义(P>0.05)。观察组愈合时间为(15.3±1.2)d,显著短于对照组的(19.1±2.0)d,差异有统计学意义(P<0.05)。结论:直肠黏膜悬吊外剥内扎术治疗混合痔疗效确切,患者切口愈合时间短,术后疼痛及肛缘水肿轻。

Objective： To evaluate the efficacy and complication of the rectal mucosa ligated with Milligan-Morgan （M-M） surgery on mixed hemorrhoids. Methods： 86 Patients with mixed hemorrhoids were divided into observation group （the rectal mucosa ligated with Milligan-Morgan） and control group （Milligan-Morgan）, according to randomized, 43 patients in each group. The efficacy, operation time, bleeding amount of the operation, anal margin edema, postoperative pain, postoperative hospital stay and heal time were observed. Results： The observation group recovered 40 patients and improved 3, and the control group recovered 39 and improved 4, the difference of efficacy was not statistically significant （P〉0.05）. The operation time of the observation group was longer than the control group [ （41.8± 9.2） min vs （35.4±10.3） min, P〈0.05]. There was no statistically difference in the volume of bleeding between two groups [ （38.4± 7.0） ml vs （35.6± 9.0） ml, P〉0.05]. The postoperative pain of the observation group was lighter than the control group [（5.3± 0.8） vs （6.7± 1.2）, P〈0.05]. The anal margin edema of the observation group was lighter than the control group [（0.9±0.8） vs （1.5±0.9）, P〈 0.05]. There was no statistical difference in the postoperative hospital stay between the two groups [（7.8± 1.7） d vs （8.3±2.0） d, P〉0.05]. The healing time of the observation group was shorter than the control group [（15.3±1.2） d vs （19.1±2.0） d, P〈0.05]. Conclusion： The rectal mucosa ligated with Milligan-Morgan was effective, shorter healing time, lighter postoperative pain and anal margin edema, compared with Milligan-Morgan.