保留齿状线外切内扎加“断桥缝合”术治疗环状混合痔的临床疗效

Clinical Efficacy of External Resection and Internal Ligation with Preserved Dentate Line Combined with"Interrupted Suture"for Treating Annular Mixed Hemorrhoids

目的:探讨保留齿状线外切内扎加“断桥缝合”术治疗环状混合痔的临床疗效。方法:选择2020年10月至2022年10月我科收治的80例环状混合痔患者,随机分为观察组和对照组,各40例,观察组行保留齿状线外切内扎加“断桥缝合”术,对照组行传统外剥内扎术,比较2组临床总体疗效、创面愈合时间,以及术后创面疼痛、肛缘水肿、创口出血情况。结果:观察组治愈38例,有效2例;对照组治愈32例,有效8例。2组总有效率均为100%。观察组术后第1、3、7天创面疼痛程度评分均低于对照组,术后肛缘水肿、创面出血程度评分均低于对照组,P<0.05。观察组创面愈合时间明显短于对照组,P<0.05。术后随访10个月,观察组肛门狭窄发生率明显低于对照组,P<0.05。结论:与传统外剥内扎术相比,保留齿状线外切内扎加“断桥缝合”术治疗环状混合痔更安全有效,且术后疼痛、水肿、出血程度更轻,创面愈合更快,肛门狭窄发生率更低,值得临床推广。

Objective To investigate the clinical efficacy of external resection and internal ligation with preserved dentate line combined with interrupted suture for treating annular mixed hemorrhoids.Meth-ods A total of 80 patients with annular mixed hemorrhoids treated in our department from October 2020 to October 2022 were randomly divided into the observation group and the control group,with 40 cases in each group.The observation group received external resection and internal ligation with preserved dentate line combined with interrupted suture,while the control group received traditional Milligan-Morgan sur-gery.The overall clinical efficacy,wound healing time,postoperative wound pain,anal edema and wound bleeding of the two groups were compared.Results Total 38 cases were cured and 2 cases were effective in observation group.In the control group,32 cases were cured and 8 cases were effective.The total effec-tive rate of both groups was 1oo%.The wound pain degree scores of the observation group were lower than those of the control group at the lst,3rd and 7th day after operation,and the scores of postoperative anal edge edema and wound bleeding were lower than those of the control group(P<0.05).The wound healing time in the observation group was significantly shorter than that in the control group(P<0.05).After 10 months of follow-up,the incidence of anal stenosis in the observation group was significantly low-er than that in the control group(P<o.05).Conclusion Compared with the traditional Milligan-Mor-gan surgery,external resection and internal ligation with preserved dentate line combined with"interrupted suture"is more safe and effective in the treatment of annular mixed hemorrhoids,with less degrees of post-operative pain,edema and bleeding,faster wound healing,and lower incidence of anal stenosis,which is worthy of clinical promotion.