选择性痔上黏膜切除钉合术结合外痔切除术治疗混合痔的临床效果研究

Study on clinical effect of tissue-selecting therapy stapler combined with external hemorrhoidectomy in the treatment of mixed hemorrhoids

目的探讨选择性痔上黏膜切除钉合术(TST)结合外痔切除术治疗混合痔患者的临床疗效。方法152例混合痔患者为研究对象,采用简单化随机法分为对照组和观察组,每组76例。对照组患者实施痔疮自动套扎术(RPH)进行治疗,观察组患者实施TST联合外痔切除术进行治疗。比较两组患者的临床疗效、术后出血评分、术后肛门疼痛评分、术后并发症发生情况。结果与对照组的88.2%比较,观察组患者的临床总有效率98.7%明显更高(P<0.05)。观察组患者术后5、10 d出血评分(0.54±0.16)、(0.15±0.03)分明显低于对照组的(1.05±0.27)、(0.77±0.18)分(P<0.05)。观察组患者术后3、5、10 d肛门疼痛视觉模拟评分法(VAS)评分(2.98±1.32)、(1.34±1.16)、(1.10±1.02)分明显低于对照组的(5.16±2.25)、(3.88±1.47)、(2.63±1.23)分(P<0.05)。与对照组的13.2%比较,观察组患者术后并发症发生率3.9%明显更低(P<0.05)。结论TST联合外痔切除术治疗混合痔患者的临床疗效显著,能够有效改善患者的临床症状,缓解术后出血和肛门疼痛,降低术后并发症发生率。

Objective To explore the clinical effect of tissue-selecting therapy stapler(TST)combined with external hemorrhoidectomy in the treatment of mixed hemorrhoids.Methods A total of 152 patients with mixed hemorrhoids were divided into a control group and an observation group by simple random method,with 76 cases in each group.The control group was treated with ruiyun procedure for hemorrhoid(RPH),and the observation group was treated with TST combined with external hemorrhoidectomy.The clinical efficacy,postoperative bleeding score,postoperative anal pain score and postoperative complications were compared between the two groups.Results The total clinical effective rate of the observation group was 98.7%,which was higher than 88.2%of the control group(P<0.05).The bleeding scores of the observation group were(0.54±0.16)and(0.15±0.03)points at 5 and 10 d after surgery,which were significantly lower than(1.05±0.27)and(0.77±0.18)points of the control group(P<0.05).The visual analogue scale(VAS)scores of patients in the observation group were(2.98±1.32),(1.34±1.16)and(1.10±1.02)points at 3,5 and 10 d after surgery,which were significantly lower than(5.16±2.25),(3.88±1.47)and(2.63±1.23)points in the control group(P<0.05).Compared with 13.2%in the control group,the postoperative complication rate of 3.9%in the observation group was significantly lower(P<0.05).Conclusion TST combined with external hemorrhoidectomy has significant clinical effect on patients with mixed hemorrhoidectomy,which can effectively improve the clinical symptoms of patients,relieve postoperative bleeding and anal pain,and reduce the incidence of postoperative complications.