RPH在Ⅲ、Ⅳ期内痔合并低位肛周脓肿手术中的应用

Application of RPH in the Treatment of Low Perianal Abscess Combined with Ⅲ、Ⅳ Internal Hemorrhoids

目的:探讨自动痔疮套扎术(RPH)治疗Ⅲ、Ⅳ期内痔合并低位肛周脓肿的临床效果。方法:选取2016年4月—2017年3月在上海中医药大学附属第七人民医院肛肠科住院的95例Ⅲ、Ⅳ期内痔合并低位肛周脓肿患者,按照随机数字表法分成两组,治疗组47例患者采用RPH+肛周脓肿一次性根治术治疗;对照组48例患者采用内痔缝扎术+肛周脓肿一次性根治术治疗,观察周期为30 d,随访2年。比较两组患者治疗效果、手术时间、手术当天夜间疼痛积分、术后首次排便疼痛积分及术后便血持续时间、术后恢复时间及术后2年内痔复发情况。结果:两组患者治疗效果、手术当天夜间疼痛积分、首次排便疼痛积分、术后2年痔复发情况比较差异无统计学意义(P>0.05);治疗组手术时间、术后便血持续时间、术后恢复时间均短于对照组(P<0.05)。结论:RPH在Ⅲ、Ⅳ期内痔合并低位肛周脓肿手术中应用的近、远期疗效确切,值得临床推广。

Objective To investigate the clinical effect of automatic hemorrhoids ligation(RPH)in the treatment of in the treatment of low perianal abscess combined withⅢ,Ⅳinternal hemorrhoids.Methods From April 2016 to March 2017,95 patients with low perianal abscess combined withⅢ,Ⅳinternal hemorrhoids in the anorectal department affiliated to Shanghai University of Traditional Chinese Medicine were divided into treatment group and control group according to the random number table.47 patients in the treatment group were treated with RPH+perianal abscess radical resection;48 patients in the control group were treated with hemorrhoid ligation+perianal abscess radical resection,the observation period was 30 days,followed up for 2 years.The treatment effect,operation time,nighttime pain score on the day of surgery,postoperative first bowel pain score and postoperative blood in the stool,postoperative recovery time and recurrence of internal hemorrhoids within 2 years after operation were compared.Results There were no significant differences between the two groups in terms of treatment effect,night pain score on the day of surgery,pain score of first bowel movement,and recurrence of internal hemorrhoids within 2 years after operation(P>0.05).The operation time,duration of postoperative blood in the treatment group,postoperative operation and the recovery time was significantly lower or shorter than that of the control group(P<0.05).Conclusion The short-term and longterm effects of RPH in the operation ofⅢ,Ⅳinternal hemorrhoids combined with low perianal abscess are accurate and worthy of clinical promotion.