PPH术治疗重度环状混合痔临床研究

Clinical research of PPH in the treatment of severe circumferential mixed hemorrhoids

目的探讨痔上黏膜环切术(PPH术)治疗重度环状混合痔临床疗效及安全性。方法 100例重度环状混合痔患者,采用随机数字表法分为对照组和试验组,每组50例。对照组患者采用外剥内扎术治疗,试验组患者采用PPH术治疗。比较两组患者手术临床指标,术前、术后1 d疼痛视觉模拟评分法(VAS)评分及术后并发症发生情况。结果对照组患者手术操作用时、手术失血量及总住院时间分别为(59.74±9.86)min、(61.32±10.48)ml、(8.34±1.41)d,试验组患者分别为(35.80±5.21)min、(29.44±5.33)ml、(5.28±0.89)d,试验组患者手术操作用时、手术失血量及总住院时间均显著少于对照组,差异具有统计学意义(P<0.05);对照组患者术前、术后1 d疼痛VAS评分分别为(9.54±0.48)、(5.45±1.30)分,试验组患者分别为(9.40±0.52)、(2.29±0.78)分,两组患者术后1 d疼痛VAS评分显著低于本组术前,且试验组患者术后1 d疼痛VAS评分低于对照组,差异具有统计学意义(P<0.05);对照组患者术后并发症发生率为14.00%,试验组患者为4.00%,试验组患者术后并发症发生率显著低于对照组,差异具有统计学意义(P<0.05)。结论 PPH术治疗重度环状混合痔可有效缩短手术操作用时和住院时间,降低手术创伤程度,减轻术后疼痛,且安全性值得认可。

Objective To investigate the clincial effect and safety of procedure for prolapsing hemorrhoids（PPH） in the treatment of severe circumferential mixed hemorrhoids. Methods A total of 100 patients with severe circumferential mixed hemorrhoids were divided into control group and experimental group according to the random number table method, 50 cases in each group. Patients in the control group were treated with milligan-morgan hemorrhoidectomy, and patients in the experimental group were treated with PPH. The clinical indexes, pain visual analogue scale（VAS） score preoperative and postoperative 1 day, the postoperative complications were compared between the two groups. Results The operative time, operative blood loss and total length of stay in the control group were（59.74±9.86） min,（61.32±10.48） ml,（8.34±1.41） d respectively, those in the experimental group were（35.80±5.21） min,（29.44±5.33） ml and（5.28±0.89） d respectively. The operative time, operative blood loss and total length of stay in the experiment group were significantly less than those in the control group, the differences were statistically significant（P〈0.05）. The pain VAS scores of control group at preoperative and postoperative 1 day were（9.54±0.48） scores and（5.45±1.30） scores respectively, those of experimental group were（9.40±0.52） scores and（2.29±0.78） scores respectively, the pain VAS scores of the two groups at postoperative 1 day were significantly lower than those at preoperative, and the pain VAS score of the experimental group at postoperative 1 day was significantly lower than that of control group, the differences were statistically significant（P〈0.05）. The incidence of postoperative complications in the control group was 14.00%, and that in the experimental group was 4.00%. The incidence of postoperative complications in the experimental group was significantly lower than that in the control group, the difference was statistically significant（P〈0.05）. Conclusion PPH for severe circumferential mixed hemorrhoids can effectively shorten the operative time and length of stay, reduce the degree of surgical trauma, alleviate postoperative pain, and the safety is recognized.