高位多点悬吊加改良外剥内扎术与RPH术治疗混合痔的效果对比分析

Comparing multiple high-level suspension and modified Milligan-Morgan surgery with Ruiyun procedure for hemorrhoids for treating mixed hemorrhoids

目的对比分析高位多点悬吊加改良外剥内扎术与自动弹力线痔套扎术(RPH)治疗混合痔的临床疗效。方法纳入2018年4月至2019年9月在南充市中心医院住院治疗的80例混合痔患者为研究对象,随机将患者分为观察组(n=40,行高位多点悬吊加改良外剥内扎术治疗)和对照组(n=40,行RPH治疗)。比较两组患者临床疗效、手术相关指标、随访3个月复发率、术后疼痛评分、术后并发症和满意度等。结果观察组术后第一次排粪时疼痛评分低于对照组,住院费用少于对照组,总满意度(95%vs.77.5%)高于对照组,且满意度优于对照组,差异均有统计学意义(均P<0.05)。两组临床有效率均为100%,随访3个月均无复发。两组临床疗效、手术时间、创面愈合时间、住院时间、疼痛评分(术后1、3、5、7天)、术后并发症(水肿、出血、排尿情况)等方面比较差异均无统计学意义(均P>0.05)。结论高位多点悬吊加改良外剥内扎术治疗混合痔可获得与RPH相似的临床疗效,均可治愈疾病,减少术后并发症,安全性好,利于患者恢复;且前者在减轻第一次排粪疼痛方面略优,住院治疗花费更低,患者满意度高,值得临床推广。

Objectives To compare the effectiveness between multiple high-level suspension and modified Milligan-Morgan sur⁃gery with Ruiyun procedure for hemorrhoids(RPH)for treating mixed hemorrhoids.Methods Eighty patients with mixed hemor⁃rhoids at the Nanchong Central Hospital between April 2018 and September 2019 were recruited and randomly assigned to the treatment group(n=40,received multiple high-level suspension and modified Milligan-Morgan surgery)and the control group(n=40,received RPH).Effectiveness,surgical parameters,recurrence at 3 months,postoperative pain,the incidence of complications,and patients’satisfaction were compared between the two groups.Results Compared with the control group,the treatment group had significantly less pain at the first defecation and less hospitalization expense.Overall satisfaction(95%vs.77.5%)was higher and satisfaction of the treatment group was better that of the control group,with statistically significant differences(P<0.05).Both groups had an effective rate of 100%.At follow-up,no patients had recurrence at 3 months.Clinical effectiveness,duration of surgery,time to wound healing,duration of hospitalization,pain scores at 1,3,5,7 days after surgery,and the incidence of com⁃plications(edema,bleeding,and problems with urination)did not differ between the two groups(P>0.05).Conclusion Multiple high-level suspension and modified Milligan-Morgan surgery can achieve comparable effectiveness as RPH.Both procedures can cure the disease and reduce postoperative complications,and are safe and beneficial for patients’recovery.Patients who receive multiple high-level suspension and modified Milligan-Morgan surgery have less pain at the first defecation,less hospitalization ex⁃pense,and better patients’satisfaction than patients who received the RPH.It has the potential for wider clinical application.