Ⅲ~Ⅳ度痔手术治疗方法及其进展

Advances in the surgical treatment of gradeⅢ~Ⅳhemorrhoids

痔病是我国常见的肛肠科疾病之一,主要表现为排便过程中无痛性出血。痔病可根据症状轻重分为Ⅰ~Ⅳ度,轻度痔通常可以通过改善生活方式或非手术方法有效缓解,而对于中重度痔(Ⅲ~Ⅳ度)、非手术治疗无效或发生并发症的病例则需要进行手术治疗。临床上常见的中重度痔手术方法有吻合器痔切除术、痔动脉结扎术、开放性痔切除术、闭合性痔切除术等。各种术式适用范围不同,各有利弊。本文总结整理了临床常用的Ⅲ~Ⅳ度痔的手术治疗方法及其进展,并对其进行比较。

Hemorrhoid is the most common anorectal disease in China.The main clinical manifestation is painless rectal bleed⁃ing during defecation.Hemorrhoids are further graded fromⅠtoⅣbased on the severity of symptoms.Low-graded hemorrhoids can usually be treated with lifestyle changes and non-operative treatment.Surgery is indicated for moderate and severe hemor⁃rhoids(gradeⅢ~Ⅳ),or when non-operative measures failed,or complications have occured.Common surgical treatments include procedure for prolapse and hemorrhoids,hemorrhoidal artery ligation,open hemorrhoidectomy,and closed hemorrhoidectomy.Each surgical treatment has its own indication,advantages,and disadvantages.In this review,we summarize and compare common sur⁃gical treatments for gradeⅢ~Ⅳhemorrhoids,and review the latest development.