PPH技术在治疗重度痔疮中的应用

Application of PPH method in the treatment of severe hemorrhoids

目的 :探讨PPH技术在治疗痔疮中的价值和手术技巧。方法 :采用美国强生公司生产的环形吻合器为 70例内痔大出血或痔脱垂作痔上粘膜切除术 ,分析手术效果和总结手术经验。结果 :手术时间 10～ 15min ,平均 12 .5min ,退出吻合器时吻合口有喷血需用缝线结扎止血的有 32例 ,占 4 5 .7% ,术后 2d出血的 1例。术后感觉疼痛者有 12例 ,占 17.1% ,所有病人均无需服用止痛药。全部病人术后 2d下床活动 ,病人观察 2～ 3d出院。痔核在术后 2d已开始回缩 ,8～ 12d痔块基本完全萎缩。全组病人无一例发生大便失禁 ,肛门狭窄感染或肛周脓肿形成。随访 1个月至 1年无复发和其它不良现象发生。结论 :PPH技术治疗内痔确实具有操作简单 ,术后痛苦少 ,恢复快 ,并发症少的优点 ,如果在手术中操作得当 。

Objective: To discuss the value and operating skill of PPH method in the treatment of hemorrhoids. Methods: By using circular stapler manufactured by Johnson-Johnson Company, Mucosectomy were taken for 70 patients with internal hemorrhoidal massive haemorrhage or hemorrhoidal prolapse. The operation effects were analysis and operation experiences were summarized. Results: Operation time was 10～15 min and 12.5 min for average.When anastomose instruments were dropped out, the stoma were bleeding and needed ligate using suture to stop bleeding in 32 patients (45.7 %). 1 Patient exist hemorrhage at the second day after operation. 12 patients(17.1%)feeled pain after opration . All patients didn't need taking anodyne and took out-of bed activaty begin at the second day after operation and discharge after observed 2～3 days. Haemorrhoids started to rebound at 2 days after operation, and hemorrhoidal mass were basically atrophy at 8～12 days. No patient was encopresis, anal stenosis infection or perianal abscess. No relapse and other bad phenomena were observed during one year's follow-up. Conclusion: PPH method has advantages such as simple operation, little postoperative pain, quick restotration, and less complications. If properly Operate, its superiority will be showed obviously.