PPH治疗症状性环状内痔

Symptomatic Circumferential Mucosectomy for the Treatment of Prolapased Hemorrhoids

目的 :探讨利用 PPH (经肛门吻合器痔上黏膜环形切除肛垫悬吊 )治疗症状性环状内痔的可行性和安全性。方法 :应用PPH治疗 5 4例有症状的环形内痔患者 ,男 30例 ,女 2 4例 ,平均年龄 6 3岁 .痔病史平均 1 1年 ,其中 6例曾接受硬化剂注射 ,4例曾接受外剥内扎手术。结果 :4 9例患者吻合后内痔立即完全回缩 ,4例于术后第 2天完全回缩 ,痔出血停止 ,1例因肛垫严重纤维化未完全回缩 ,术后第 7天行外剥内扎手术。术后尿潴留 6例 ,无肛门疼痛及出血。术后平均住院 4 d,随访 1周至 2个月。术后 2周开始痔核萎缩 ,无大便失禁和复发。结论 :PPH治疗症状性环状内痔具有疗效显著、手术简单、术后痛苦少 ,术后并发症少、恢复正常生活早、住院时间短等特点 ,并对出口梗阻型便秘症状有效 。

Objective:To evaluate symptomatic circumferential mucosectomy for the treatment of prolapased hemorrhoids.Methods:54 patients with symptomatic circular hemorrhoids were operated on with PPH.The mean age was 63 years with hemorrhoids history of 11years.Results:Hemorrhoids in 49 disappeared immediately after operation ,and 4 disappeared on the second day.No annal spasm or bleeding ensued. The mean postoperative hospital stay was 4 days.Conclusion:The new technique provides a significantly less painful choice of treatment for symptomatic hemorrhoids.However,the long term outcome remains to be identified.