PPH联合部分肛门括约肌切断术对重度混合痔患者创缘水肿及疼痛程度的影响

Effect of PPH Combined with Partial Anal Sphincterotomy on Traumatic Edge Edema and Pain in Patients with Severe Mixed Hemorrhoids

目的探讨吻合器痔上黏膜环切术(PPH)联合部分肛门括约肌切断术对重度混合痔患者创缘水肿及疼痛程度的影响。方法选择该院2022年1月—2023年6月收治的72例重度混合痔患者为研究对象,按随机数字表法将其分为对照组与观察组,各36例。对照组采用PPH治疗,观察组在对照组基础上加用部分肛门括约肌切断术治疗。比较两组创缘水肿、疼痛程度、肛门功能及并发症发生情况。结果术后2周,两组创缘水肿、视觉模拟评分均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。术后2周,两组肛管静息压均降低,且观察组低于对照组,舒张压均升高,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率为2.78%,低于对照组的22.22%,差异有统计学意义(P<0.05)。结论重度混合痔患者采用PPH联合部分肛门括约肌切断术治疗的效果确切,利于改善创缘水肿及疼痛程度,促进患者肛门功能恢复,减少相关并发症的发生,值得推广应用。

Objective To investigate the effects of procedure for prolapse and hemorrhoids(PPH)combined with partial anal sphincterotomy on traumatic edge edema and pain in patients with severe mixed hemorrhoids.Methods A total of 72 patients with severe mixed hemorrhoids admitted to the hospital from January 2022 to June 2023 were selected as the study objects,and were divided into a control group and an observation group according to random number table method,with 36 cases in each group.The control group was treated with PPH,and the observation group was treated with partial anal sphincterotomy on the basis of the control group.The traumatic edge edema,pain degree,anal function and complications were compared between the two groups.Results 2 weeks after surgery,the scores of traumatic edge edema and visual analogue scale were decreased,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).2 weeks after surgery,the resting pressure of anal canal in both groups were decreased,and the observation group was lower than the control group;the diastolic pressure were increased,and the observation group was higher than the control group,the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was 2.78%,lower than 22.22%in the control group,and the difference was statistically significant(P<0.05).Conclusion The treatment effect of PPH combined with partial anal sphincterotomy for severe mixed hemorrhoids is accurate,which can improve the degree of traumatic edema and pain,promote the recovery of anal function of patients,and reduce the occurrence of related complications,and is worthy of promotion and application.