自动弹力线套扎术联合外痔切除缝合术治疗环状混合痔41例疗效观察

Efficacy Observation of Automatic Elastic Suture Ligation in Combination with External Hemorrhoidectomy and Suture in Treatment of 41 Cases of Annular Mixed Hemorrhoids

目的:探讨自动弹力线套扎术(RPH-4)联合外痔切除缝合术治疗环状混合痔的临床效果及安全性。方法:选取2020年4月至2022年4月,本院收治的82例环状混合痔患者,按随机数字表法分为观察组和对照组,各41例。观察组采用RPH-4联合外痔切除缝合术治疗,对照组采用传统外剥内扎术治疗。比较2组手术相关指标、疼痛评分、肛肠动力学指标及并发症。结果:观察组手术时间、肛门肿痛消退时间及愈合时间均短于对照组(P<0.05),术中出血量少于对照组(P<0.05)。观察组术后6 h、12 h、24 h和48 h的疼痛评分均低于对照组(P<0.05),术后肛管静息压、肛管最大收缩压、直肠最大耐受量、直肠感觉阈值均低于对照组(P<0.05),并发症发生率低于对照组(P<0.05)。结论:RPH-4联合外痔切除缝合术治疗环状混合痔效果更佳,能够缩短手术时间,减轻手术创伤,降低术后疼痛,改善肛肠动力学指标,且并发症少。

Objective To investigate the clinical effect and safety of automatic elastic suture ligation(RPH-4)in combination with external hemorrhoidectomy and suture in the treatment of annular mixed hemorrhoids.Methods Total 82 patients with annular mixed hemorrhoids treated in our hospital from April 2020 to April 2022 were selected and divided into the observation group and the control group accord-ing to the random number table method,with 41 cases in each group.The observation group was treated with RPH-4 in combination with external hemorrhoidectomy and suture,while the control group was trea-ted with Milligan-Morgan hemorrhoi dectomy.The operation-related indexes,pain scores,anorectal dy-namic indexes and complications were compared between the two groups.Results The operation dura-tion,the subsidence time and healing time of anal swelling pain in the observation group were shorter than those in the control group(P<0.05).The intraoperative blood loss in the observation group was less than that in the control group(P<0.05).The pain scores at 6 h,12 h,24 h and 48 h after operation in the observation group were lower than those in the control group(P<0.05).The postoperative anal rest-ing pressure,anal maximum systolic pressure,rectal maximum tolerance and rectal sensory threshold were lower than those in the control group(P<0.05).The incidence of complications was lower than that in the control group(P<0.05).Conclusion RPH-4 in combination with external hemorrhoidecto-my and suture is more effective in the treatment of annular mixed hemorrhoids,which can shorten the op-eration duration,reduce surgical trauma,relieve postoperative pain,improve anorectal dynamic indexes,and have fewer complications.