传统手术与选择性痔上黏膜切除吻合术治疗重度痔疮的效果比较

Comparison of the effects of traditional operation and selective hemorrhoidectomy and anastomosis in the treatment of severe hemorrhoids

目的比较传统手术与选择性痔上黏膜切除吻合术治疗重度痔疮的效果。方法选择2019年1月至2020年12月本院接收的120例重度痔疮患者为研究对象,根据随机数字表法将其分为对照组和观察组,每组60例。对照组实施传统手术治疗,观察组实施选择性痔上黏膜切除吻合术治疗。比较两组的治疗效果。结果观察组的术中出血量少于对照组,手术时间、术后排气时间、排便恢复时间、住院时间、创口愈合时间均短于对照组(P<0.05)。术后第1、3天,两组排便时的数字评价量表(NRS)评分均低于术前,且观察组低于对照组(P<0.05)。术后第3天,两组的中性粒细胞与淋巴细胞比值(NLR)、血小板计数与淋巴细胞比值(PLR)均低于术前,且观察组低于对照组(P<0.05)。观察组的肛门瘙痒、肛门肿胀、便血、疼痛缓解时间均短于对照组(P<0.05)。术后2周,观察组的肛管静息压、肛管最大收缩压以及弗罗里达克里夫兰诊所便失禁评分(CCF-FIS)低于对照组,直肠感知阈值高于对照组(P<0.05)。观察组的治疗总有效率高于对照组,并发症总发生率低于对照组(P<0.05)。结论同传统手术进行比较,选择性痔上黏膜切除吻合术应用在重度痔疮治疗中效果显著,有助于改善患者的临床症状及预后,且安全性高,值得推广。

Objective To compare the effects of traditional operation and selective hemorrhoidectomy and anastomosis in the treatment of severe hemorrhoids.Methods A total of 120 patients with severe hemorrhoids received by our hospital from January 2019 to December 2020 were selected as the research objects,and divided into control group and observation group according to random number table method,with 60 cases in each group.The control group was treated with traditional operation,and the observation group was treated with selective hemorrhoidectomy and anastomosis.The therapeutic effects of the two groups were compared.Results The amount of intraoperative bleeding in the observation group was less than that in the control group,operation time,postoperative exhaust time,defecation recovery time,hospital stay and wound healing time in the observation group were shorter than those in the control group(P<0.05).On the 1st and 3rd day after operation,the numerical rating scale(NRS)score of defecation in both groups was lower than that before operation,and that in the observation group was lower than the control group(P<0.05).On the 2nd after operation neutrophil to lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in both groups were lower than those before operation,and those in the observation group were lower than the control group(P<0.05).The remission time of anal itching,anal swelling,hematochezia and pain in the observation group were shorter than those in the control group(P<0.05).Two weeks after operation,anal resting pressure,maximum anal systolic pressure and Cleveland clinic Florida faecal incontinence scores(CCF-FIS)in the observation group were lower than those in the control group,and rectal perception threshold was higher than that in the control group(P<0.05).The total effective rate of treatment in the observation group was higher than that in the control group,and the total incidence of complications was lower than that in the control group(P<0.05).Conclusion Compared with traditional operation,selective hemorrhoidectomy and anastomosis has a significant effect in the treatment of severe hemorrhoids,it is helpful to improve the clinical symptoms and prognosis of patients,with high safety,which is worth popularizing.