PPH与外剥内扎术治疗对混合痔患者术后疼痛及肛门功能的影响比较

Comparison of the Effects of PPH and Milligan-Morgan Hemorrhoidectomy on Postoperative Pain and Anal Function in Patients with Mixed Hemorrhoids

目的 分析对比吻合器痔上黏膜环形切除术(procedure for prolapse and hemorrhoids, PPH)与外剥内扎术在混合痔患者中的应用效果。方法 便利选取2020年4月—2021年4月湄潭县中西医结合医院收治的90例混合痔患者为研究对象,根据治疗方法不同分成两组,各45例。对照组行外剥内扎术,观察组行PPH,观察到术后3个月。对比两组手术情况、疼痛程度、肛门功能、并发症。结果 观察组的手术时间为(25.64±2.01)min、住院时间为(5.26±1.14)d、首次排便时间为(1.67±0.25)d,短于对照组的(37.45±2.89)min、(6.31±1.59)d、(2.53±0.48)d,差异有统计学意义(t=22.505、3.600、10.660,P均<0.05)。术后3 d,观察组的视觉模拟评分法评分为(2.83±0.40)分,低于对照组的(3.71±0.52)分,差异有统计学意义(t=8.998,P<0.05)。观察组的并发症发生率低于对照组,差异有统计学意义(P<0.05)。术前,两组直肠最大耐受容量(maximal tolerable rectal volume, MTV)、直肠静息压(resting rectal pressure, RRP)、肛管最大收缩压(maximum squeeze pressure,MSP)相比,差异无统计学意义(P均>0.05);术后,观察组的MTV、MSP高于对照组,RRP低于对照组,差异有统计学意义(P均<0.05)。结论 PHH手术时间短,能缓解混合痔患者术后疼痛,并发症发生率低,对患者肛门排便功能影响较小。

Objective The effects of procedure for prolapse and hemorrhoids(PPH)and Milligan-Morgan hemorrhoidectomy in patients with mixed hemorrhoids were analyzed and compared.Methods From April 2020 to April 2021,90 patients with mixed hemorrhoids admitted to Meitan County Hospital of Combination of Chinese and Western Medicine were conveniently selected as the research objects.According to different treatment methods,they were divided into two groups,45 cases in each group.The control group was treated with Milligan-Morgan hemorrhoidectomy,and the observation group was treated with PPH,which was observed for 3 months after operation.The operation condition,pain degree,anal function and complications were compared between the two groups.Results The operation time of the observation group was(25.64±2.01)min,the hospitalization time was(5.26±1.14)d,and the first defecation time was(1.67±0.25)d,which were shorter than the control group's(37.45±2.89)min,(6.31±1.59)d,(2.53±0.48)d,the differences were statistically significant(t=22.505,3.600,10.660,all P<0.05).At 3 days after operation,the Visual Analogue Scale score of the observation group was(2.83±0.40)points,which was lower than the control group's(3.71±0.52)points,and the difference was statistically significant(t=8.998,P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Before operation,there was no significant difference in maximal tolerable rectal volume(MTV),rectal resting pressure(RRP)and maximum squeeze pressure(MSP)between the two groups(all P>0.05);after operation,the MTV and MSP of the observation group were higher than those of the control group,and the RRP was lower than that of the control group,the differences were statistically significant(all P<0.05).Conclusion The operation time of PHH is short,which can relieve the postoperative pain of patients with mixed hemorrhoids.The incidence of complications is low,and it has little effect on the anal defecation function of patients.