外剥内扎术联合皮桥重建术治疗环状混合痔的临床效果

Clinical effect of milligan-morgan hemorrhoidectomy combined with skin bridge reconstruction on circular mixed hemorrhoid

目的探讨外剥内扎术联合皮桥重建术治疗环状混合痔的临床效果。方法对我院2015年9月至2017年9月收治的120例环状混合痔患者的临床资料进行前瞻性研究,根据就诊顺序将患者分为对照组和研究组,每组60例。对照组实施外剥内扎术治疗,研究组实施外剥内扎术联合皮桥重建术治疗。比较两组的临床疗效、术后不同时间创面疼痛程度、治疗情况及术后并发症发生情况。结果研究组患者的治疗总有效率为98.33%,明显高于对照组的88.33%,差异具有统计学意义(P<0.05)。术后24 h、第一次排便、术后1、2周,研究组患者的VAS评分均显著低于对照组,差异具有统计学意义(P<0.05)。研究组患者手术时间长于对照组,住院时间及恢复工作时间均显著短于对照组,差异具有统计学意义(P<0.05)。术后随访3个月,研究组患者的肛缘水肿、尿潴留、肛门狭窄坠胀及迟发性出血发生率均显著低于对照组,差异具有统计学意义(P<0.05)。结论外剥内扎术联合皮桥重建术治疗环状混合痔效果显著,其可有效减轻患者术后疼痛程度,促进创面愈合,缩短治疗周期,且术后并发症少,值得临床推广应用。

Objective To investigate the clinical effect of milligan-morgan hemorrhoidectomy combined with skin bridge reconstruction on circular mixed hemorrhoid. Methods The clinical data of 120 patients with circular mixed hemorrhoid admitted in our hospital from September 2015 to September 2017 were prospectively studied. The patients were divided into control group and study group according to the order of treatment, with 60 cases in each group. The control group was treated with milligan-morgan hemorrhoidectomy, while the study group was treated with milligan-morgan hemorrhoidectomy combined with skin bridge reconstruction. The clinical efficacy, the degree of wound pain at different postoperative time,the treatment situation and the incidence of postoperative complications were compared between the two groups. Results The total effective rate of treatment in the study group was 98.33%, which was significantly higher than 88.33% of the control group, and the difference was statistically significant(P<0.05). The VAS scores of the study group were significantly lower than those of the control group at postoperative 24 h, the first defecation, postoperative 1 and 2 weeks, and the differences were statistically significant(P<0.05). The operation time of the study group was longer than that of the control group, the hospital stay and recovery time were significantly shorter than those of the control group, and the differences were statistically significant(P <0.05). After 3 months of follow-up, the incidences of anal marginal edema, urinary retention, anal stenosis and swelling and delayed hemorrhage in the study group were significantly lower than those in the control group, and the differences were statistically significant(P<0.05). Conclusion Milligan-morgan hemorrhoidectomy combined with skin bridge reconstruction is effective in the treatment of circular mixed hemorrhoid. It can effectively alleviate the degree of postoperative pain, promote wound healing, shorten the treatment cycle, with fewer complications,which is worthy of clinical promotion and application.