PPH与改良分段外剥内扎术治疗环状混合痔的临床疗效对比分析

Comparison Analysis on the Clinical Effects of Circumferential Mixed Hemorrhoids Treated with PPH and Modified Segmental External Dissection and Internal Ligation

为比较吻合器痔上黏膜环切术(PPH)与改良分段外剥内扎术治疗环状混合痔的临床疗效,选择2017年我科收治的122例环状混合痔患者作为研究对象,随机分为A组和B组,各61例,A组行改良分段外剥内扎术治疗,B组行PPH治疗。比较2组总体疗效,术后疼痛、水肿、肛门狭窄及失禁发生情况,创面愈合时间,手术费用。结果显示,2组总有效率均为98.36%(60/61),差异无统计学意义,P>0.05。A组术后8h及首次排便时疼痛评分均明显高于B组,且A组肛门中重度水肿发生率高于B组,P<0.05;A组未发生肛门狭窄、肛门失禁,B组肛门狭窄2例(经扩肛治愈),肛门失禁3例(一过性);A组创面愈合时间长于B组,P<0.05;A组手术费用少于B组,P<0.05。结果表明,PPH与改良分段外剥结扎术治疗环状混合痔均可取得较好的临床疗效,在术后疼痛、水肿、创面愈合时间方面PPH优于改良分段外剥内扎术,在手术费用、肛门狭窄和肛门失禁方面改良分段外剥内扎术优于PPH。临床可根据具体情况选择术式。

This study was to investigae and compare the clinical effects of circumferential mixed hemorrhoids treated with PPH and modified segmental external dissection and internal ligation,enrolled 122 cases of this hemorrhoids treated in author’s department in 2017 yr.as research objects,and randomly divided them into group A and group B,61 cases for each;group A received modified segmental external dissection and internal ligation,group B received PPH;then compared general effect;the status on postoperative pain,edema,anal stenosis and anal incontinence;wound-surface healing time,as well cost for operation between the two groups.As results,the total effective rate of both groups was 98.36%(60/61),in total effective rate there was no statistical difference between the two groups(P>0.05);in group A the score rating on pain at 8 hrs and first-time defecation after surgery were significantly higher than that in group B;also,the incidence of anal moderate and severe edema higher than that in group B(P<0.05);in group A no anal stenosis and incontinence occured,meanwhile in group B 2 cases suffered from anal stenosis(then were cured through anal dilatation),and 3 cases from anal incontinence(belong to transient one);the healing time of wound-surface in group A was longer than that in group B(P<0.05),the operation cost in group A was less than that in group B(P<0.05).Results show that both procedures can all obtain better effect clinically,but in postoperative pain,edema and wound-surface healing time PPH is superior to modified segmental external dissection and internal ligation;in operation cost as well in anal stenosis and incontinence modified segmental external dissection and internal ligation is yet superior to PPH,therefore clinically it might be according to concrete condition to choose relevant procedure.