肛垫切除术治疗Ⅲ、Ⅳ期环状痔

Anal cushion resection versus Milligan-Morgan hemorrhoidectomy for circular hemorrhoids:randomized controlled trial

目的比较肛垫切除术和外剥内扎术治疗Ⅲ、Ⅳ期环状痔的临床效果。方法48例Ⅲ、Ⅳ期环状痔患者随机分成两组,分别接受肛垫切除术和外剥内扎术治疗。比较两组患者的术后疼痛评分、手术时间、创面愈合时间、平均住院时间、术后并发症的发生率以及疗效。结果两组患者术后的疼痛评分无显著性差异。肛垫切除术手术时间长于外剥内扎术,但术后创面愈合时间、平均住院时间和术后并发症明显少于对照组。肛垫切除术的疗效明显优于外剥内扎术。结论肛垫切除术治疗Ⅲ、Ⅳ期环状痔的疗效确切,并发症轻,是一种安全有效的手术方式。

Objective To compare the clinical effect of anal cushion resection with Milligan-Morgan hemorrhoidectomy for the third- or fourth-degree circular hemorrhoids. Methods Forty-eight patients with third- or fourth-degree circular hemor-rhoids were randomly assigned into two groups to receive either anal cushion resection or Milligan-Morgan hemorrhoidecto-my. Comparison of the two approaches were conducted in terms of postoperative pain scores, operation time, wound healing time, mean hospital stay, incidence of postoperative complications and the curative effect. Results No significant difference was found in view of postoperative pain scores according to visual analogue scale between the 2 groups. The operative time of anal cushion resection was significantly longer than that of the other group, however, its wound healing time, mean hospital stay and incidence of postoperative complications were significantly less. Follow-up study for 3 months after operation found that anal cushion resection had significantly better curative effect than Milligan-Morgan hemorrhoidectomy. Conclusion Anal cushion resection is a safe and practical approach for third- or fourth-degree circular hemorrhoids.