改良PPH治疗重度混合痔的效果及对围术期应激指标的影响

Effect of modified PPH in the treatment of severe mixed hemorrhoids and its effect on perioperative stress indicators

目的探讨对重度混合痔患者实施改良吻合器痔上黏膜环切术(PPH)的效果及围术期应激指标变化。方法将90例重度混合痔患者采用随机数字表分为常规组(45例,常规PPH手术治疗)和改良组(45例,改良PPH手术治疗)。对比两组手术指标、围术期应激指标及并发症情况。结果与常规组比较,改良组手术时间和术后住院时间均更短(P<0.05);两组术后1 d血浆肾上腺素(E)、去甲肾上腺素(NE)水平均升高(P<0.05);两组术后3 d血浆E、NE均低于术后1 d,均高于术前(P<0.05);且改良组术后血浆E、NE水平均更低(P<0.05);改良组并发症总发生率更低(P<0.05)。结论对重度混合痔患者实施改良PPH手术操作迅速,术后恢复快,围术期应激指标变化幅度小,且安全性高。

Objective To investigate the effect of modified procedure for prolapse and hemorrhoids（PPH） on severe mixed hemorrhoids and the changes of perioperative stress indicators. Methods Niety patients with severe mixed hemorrhoids were divided into routine group（45 cases, routine PPH operation treatment） and modified group（45 cases, modified PPH operation treatment） according to the random digital table. The operative indexes, perioperative stress indicators and complications were compared between the two groups. Results Compared with the routine group, the operative time and postoperative hospital stay in the modified group were significantly shorter（P〈0.05）. The levels of plasma epinephrine（E） and norepinephrine（NE）in the two groups increased after 1 d of operation（P〈0.05）, the levels of plasma E and NE after 3 d of operation were lower than those after 1 d of operation, and were higher than those before operation（P〈0.05）, and those in the modified group after operation were lower than that of the routine group（P〈0.05）. The total incidence rate of complications in the modified group was lower than that of the routine group（P〈0.05）. Conclusion The operation of modified PPH for severe mixed hemorrhoids is fast, with quick recovery after operation, and little change in perioperative stress indicators, and with high safety.