分段剥离保留皮瓣法治疗重度混合痔临床观察

Clinical observation on segmental dissection and preservation of skin flaps in treatment of severe mixed hemorrhoids

目的观察采用分段剥离保留皮瓣法手术治疗重度混合痔的疗效。方法将72例Ⅲ、Ⅳ度混合痔手术患者随机分为试验组、对照组两组,每组36例。试验组采用分段剥离保留皮瓣法手术;对照组采用传统外剥内扎术手术。观察、统计两组手术时间、术中出血量、术后疼痛、局部水肿、愈合时间,手术满意度情况。结果两组患者有效率均为100%,无统计学差异。对照组出现肛门狭窄4例,试验组无肛门狭窄,两组间存在统计学差异。试验组手术出血量、VAS疼痛评分、局部水肿程度积分、创面愈合时间、满意度均优于对照组,手术时间长于对照组,均存在统计学差异。结论该手术方法临床效果显著,值得推广。

Objective To observe the effect of segmental dissection and preservation of skin flaps on severe mixed hemorrhoids. Methods A total of 72 patients with mixed hemorrhoids of grade Ⅲ and Ⅳ were randomly divided into experimental group and control group, with 36 cases in each group.The experimental group received segmental dissection and preservation of skin flaps, while the control group received traditional external dissection and internal ligation.The operation time, intraoperative bleeding volume, postoperative pain, local edema, healing time, and surgical satisfaction of the two groups were recorded. Results The effective rates of both groups were 100%, without statistical difference.There were 4 cases of anal stenosis in the control group and no anal stenosis case in the experimental group, with statistical difference.The experimental group showed less intraoperative bleeding volume, lower VAS pain score, lower local edema score, shorter wound healing time, higher satisfaction, and longer operation time than the control group, with statistical differences. Conclusion The clinical effect of segmental dissection and preservation of skin flaps on severe mixed hemorrhoids deserves popularizing.