选择性痔上黏膜切除吻合术治疗环状混合痔的疗效及对肛肠动力学的影响

The Effect of Tissue-selecting Therapy for Circumferential Mixed Hemorrhoids,and its Influence on patients’ Coloproctological Dynamics

目的:观察选择性痔上黏膜切除吻合术(TST)治疗环状混合痔的疗效及对肛肠动力学的影响。方法:将100例环状混合痔患者随机分为观察组和对照组,各50例。观察组采用TST治疗,对照组采用外剥内扎术治疗。比较2组患者手术时间、术中出血量、首次排便时间、术后疼痛评分和肛门功能等指标。结果:观察组患者手术时间、术中出血量、首次排便时间、创面痊愈时间、术后疼痛评分均明显少于对照组,术后并发症发生率低于对照组,差异有统计学意义(P <0.05)。术后3个月观察组的直肠感觉阈值高于对照组,肛管静息压及肛管最大收缩压均低于对照组,差异有统计学意义(P <0.05)。结论:TST治疗环状混合痔可以显著提高疗效,缩短手术时间,减少术中出血和术后疼痛,加速创面愈合,有效改善肛肠动力,降低术后并发症发生率,值得临床推广应用。

Objective To investigate the effect of tissue-selecting therapy(TST) for circumferential mixed hemorrhoids(CMH),and its influence on patients’ coloproctological dynamics.Methods Randomly divided 100 CMH patients treated in author’s hospital into observation group(50 cases,received TST)and control group(50 cases, external dissection & internal ligature);then, compared operting time, intraoperative bleeding volume,the time for first defecation,wound-surface healing time,the ratings on postoperative pain,and anal function,etc.between the two groups.Results In above-mentioned first 5 items,observation group was all less than control group;its postoperative complication incidence also lower than control group(all,P <0.05).At 3 months after surgery,in rectal sensitivity threshold,as well as in anal resting pressure and max.systolic pressure,observation group was respectively higher,as well as lower than control group(P <0.05).Conclusion TST for CMH can significantly enhance effect,shorten operating time,reduce intraoperative bleeding volume and patients’ pain,accelerate wound-surface healing, effectively improve coloproctological dynamics,and decrease the incidence of postoperative complication,thus is worthy to be popularized to used clinically.