外剥内扎术联合手法扩肛治疗环状混合痔

Treatment of annular mixed hemorrhoids with external stripping and internal ligation combined with manual anal dilatation

目的观察外剥内扎术联合手法扩肛治疗环状混合痔中的临床价值。方法将90例环状痔患者随机分成三组,每组30例,治疗组(手法扩肛+外剥内扎术),对照组(内括约肌侧切+外剥内扎术),空白组(外剥内扎术);对三组患者术后并发症情况对比分析。结果术后疼痛:治疗组、对照组分别与空白组比较差异均有统计学意义(P<0.05),治疗组和对照组比较差异无统计学意义(P>0.05);肛门狭窄:治疗组和对照组分别有1例,空白组出现6例,三组比较差异有统计学意义(P<0.05);肛门失禁:治疗组、空白组分别与对照组比较差异均有统计学意义(P<0.05),治疗组和空白组比较差异无统计学意义(P>0.05)。结论手法扩肛对减轻环状混合痔术后疼痛及减少肛门狭窄发生率有一定疗效,又能最大程度地维护肛门的自制功能。

【Objective】To observe the clinical value of external stripping and internal ligation combined with manual anal dilatation in treatment of annular mixed hemorrhoids.【Methods】Ninety cases of ring-like hemorrhoids randomly divided into three groups:30 cases in each group,treatment group(manual anus dilatation plus external stripping and internal ligature),control group(internal sphincter-side cutting plus external stripping and internal ligature),blank group(external stripping and internal ligature),and postoperative complications of three groups of patients were comparatively analyzed.【Results】Postoperative pain:there was significant difference between the treatment group and the blank group,the control group and the blank group(P<0.05),but there was no significant difference between the treatment group and the control group(P>0.05).Anal stricture:there were 1 case in the treatment group and 1 case in the control group,and 6 cases in the blank group;there was significant difference among the three groups(P<0.05).Anal incontinence:there was significant difference between the treatment group and the control group,the blank group and the comtrol group(P<0.05),but there was no significant difference between the treatment group and the blank group(P>0.05).【Conclusion】manual anal dilatation is effective in relieving pain and reducing the incidence of anal stricture after annular mixed hemorrhoids,and can maintain the self-made function of anus to the greatest extent.