选择性痔上黏膜切除术(TST)与吻合器黏膜环切术(PPH)治疗混合痔的疗效比较

Efficacy comparison between tissue selective therapy(TST)and procedure for prolapse and hemorrhoids(PPH)for mixed hemorrhoids

目的比较选择性痔上黏膜切除术(TST)与吻合器黏膜环切术(PPH)治疗混合痔的疗效。方法选取2018年1月~2020年1月我院收治的60例混合痔患者作为研究对象,均为典型混合痔,全部患者根据治疗方法不同分为TST组和PPH组,每组各30例,比较两组的各项手术观察指标、VAS评分、术后并发症情况。结果观察组患者的手术时间为(11.3±2.9)min,术中出血量为(5.1±1.8)mL,住院时间为(5.2±1.7)d,分别与对照组患者的手术时间为(25.1±3.7)min,术中出血量为(12.9±2.1)mL,住院时间为(11.5±2.3)d比较,差异有统计学意义(P<0.05)。观察组患者的VAS评分显著低于对照组,差异有统计学意义(P<0.05)。观察组患者术后无一例出现尿潴留、肛门水肿,对照组患者术后出现尿潴留6例,肛门水肿1例,观察组患者术后并发症发生率为6.7%,显著低于对照组,差异有统计学意义(P<0.05)。结论选择性痔上黏膜切除术(TST)较吻合器黏膜环切术(PPH)治疗混合痔的疗效更佳,可以显著缩短手术时间,减少出血量、缩短手术时间,减轻患者的疼痛,减少术后并发症的发生率。

Objective To compare the efficacy of tissue selective therapy(TST)and procedure for prolapse and hemorrhoids(PPH)in the treatment of mixed hemorrhoids.Methods Sixty patients with mixed hemorrhoids admitted in our hospital from January 2018 to January 2020 were selected as the research objects,all of which were typical mixed hemorrhoids.All patients were divided into TST group and PPH group according to different treatment methods,with 30 cases in each group.The observation indexes,VAS scores and postoperative complications between the two groups were compared.Results There were significant differences in the operation time([11.3±2.9]min vs[25.1±3.7]min),the intraoperative blood loss([5.1±1.8]mL vs[12.9±2.1]mL),and the hospitalization time([5.2±1.7]d vs[11.5±2.3]d)between the observation group and the control group(P<0.05).The VAS score of the observation group was significantly lower than that of the control group.There was significant difference in the pain score between the two groups,P<0.05.None of the patients in the observation group had urinary retention and anal edema after operation.6 patients in the control group had urinary retention and 1had anal edema.The incidence of postoperative complications in the observation group was 6.7%,which was significantly lower than that in the control group,P<0.05.Conclusions Tissue selective therapy(TST)is more effective than procedure for prolapse(PPH)in the treatment of mixed hemorrhoids.It can significantly shorten the operation time,reduce the amount of bleeding,shorten the operation time,reduce patient pain,and reduce the incidence of postoperative complications.