PPH联合缝扎术治疗对重度环状混合痔患者手术相关指标及肛门功能的影响

Effect of PPH Combined with Suture and Ligation Surgery on Surgical Indicators and Anal Function in Patients with Severe Annular Mixed Hemorrhoids

目的探讨吻合器痔上黏膜环切术(PPH)联合缝扎术治疗对重度环状混合痔患者手术相关指标及肛门功能的影响。方法选取2022年1月—2023年9月浙江省人民医院毕节医院收治的80例重度环状混合痔患者为研究对象,按照随机数字表法将其分为对照组和观察组,每组40例。对照组采用PPH治疗,观察组采用PPH联合缝扎术治疗。比较两组患者的临床疗效、手术相关指标、肛门功能及并发症发生情况。结果观察组治疗总有效率为97.50%,高于对照组的80.00%,差异有统计学意义(P<0.05)。观察组手术时间为(25.13±1.52)min,长于对照组,疼痛消失时间为(3.62±1.24)d,创面愈合时间为(6.13±1.02)d,住院时间为(7.24±1.83)d,均短于对照组,肛管静息压为(10.18±2.12)kPa,便秘评分量表评分为(7.12±1.43)分,均低于对照组,肛管舒张压为(6.13±1.04)kPa,高于对照组,组间差异有统计学意义(P<0.05)。观察组并发症发生率为5.00%,低于对照组的20.00%,差异有统计学意义(P<0.05)。两组术中出血量比较,差异无统计学意义(P>0.05)。结论PPH与缝扎术联合治疗重度环状混合痔患者效果显著,可有效改善手术相关指标,提升患者肛门功能,降低术后并发症发生率。

Objective To investigate the effect of procedure for prolapse and hemorrhoids(PPH)combined with sutures and ligation surgery on surgical indicators and anal function in patients with severe annular mixed hemorrhoids.Methods Eighty patients with severe annular mixed hemorrhoids admitted to Zhejiang Provincial People's Hospital Bijie Hospital from January 2022 to September 2023 were selected as the research objects,and were divided into a control group and an observation group according to random number table method,with 40 cases in each group.The control group was treated with PPH,and the observation group was treated with PPH combined with suture and ligation surgery.The clinical efficacy,surgical indicators,anal function and complications were compared between the two groups.Results The total effective rate of the observation group was 97.50%,which was higher than 80.00%of the control group,and the difference was statistically significant(P<0.05).The operation time of the observation group was(25.13±1.52)min,which was longer than that of the control group,the time for pain to disappear was(3.62±1.24)d,the time for wound healing was(6.13±1.02)d,the time for hospitalization was(7.24±1.83)d,all of which were shorter than those of the control group,the resting pressure of anal canal was(10.18±2.12)kPa,the score of constipation rating scale was(7.12±1.43)points,both were lower than those of the control group,and the diastolic pressure of anal canal was(6.13±1.04)kPa,which was higher than that of the control group,with statistical significance between groups(P<0.05).The incidence of complications in the observation group was 5.00%,which was lower than 20.00% in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in intraoperative blood loss between the two groups(P>0.05).Conclusion The combination of PPH and suture and ligation surgery is effective in the treatment of severe annular mixed hemorrhoids,which can effectively improve surgical indicators,improve the anal function of patients,and reduce the incidence of postoperative complications.