保留肛垫ATZ上皮中医结扎术治疗环状混合痔

The ligation method of preserve ATZ in the surgical operation of circumferential mixed hemorrhoids

目的 :探讨保留肛管移行区 (analtransitionalzone ,ATZ)上皮中医结扎术治疗环状混合痔的手术疗效。方法 :采用保留ATZ术治疗 70例 (治疗组 ) ,并与采用分段外剥内扎术治疗 4 5例 (对照组 )作对照观察 ,治疗组首先以幽门螺杆菌美蓝染色液对肛缘至齿线上 5cm处染色 ,ATZ显示淡蓝色 ,再对内外痔各分为 3～5个部位交叉排列式结扎 ,术中尽量保存ATZ。结果 :两组全部治愈 ,治疗组疗程缩短 ,治疗组治愈天数 ( 16 .81± 2 .31)d ,对照组治愈天数 ( 18.93± 2 .90 )d ,两组差异有统计学意义 (P <0 .0 0 1) ,治疗组几乎避免了术后肛管狭窄、直肠粘膜脱垂、排便困难、感觉性肛门失禁等并发症的发生 ,两组差异有统计学意义 (P <0 .0 5 )。结论 :注重保留肛垫ATZ上皮及采用具有中医特色的结扎术 ,既有效地切除了环状痔核 ,又能保护肛门的正常功能 。

Objective:To investigate a new surgical operation that ligation method of preserve ATZ for circumferential mixed hemorrhoids.Methods:The new method with 70 cases(treatment group). Traditional hemorrhoidectomy method with 45 cases(control group). The area from anal border to 5 cm above the dentate line was stained by helicobacter pylori methylene blue coloring agent. ATZ showed light blue. The circumferntial mixed hemorrhoids adoption cross alignment ligation on different plane. ATZ was retained best.Results:The treatment group cure days is (16.81±2.31),the control group cure days is (18.93±2.90). There is a marked statistical difference between the two groups(P<0.001). The occur rate of postoperative complications is very low with treatment group,for instance anus narrow and rectal prolapse and difficult defecation and light anus incontinence(P<0.05).Conclusion:The new operation adopted TCM ligation method,can protect anal function. This is a satisfied method.