PPH治疗重度痔疮的价值和技巧

To treat severe hemorrhoids by PPH

目的 探讨吻合器痔环状切除术 (PPH)治疗重度痔的价值和手术技巧。方法 用PPH治疗重度内痔患者 80例 ,分析手术效果 ,总结手术经验。结果 手术时间 15～ 2 5min ,平均 2 0min ,退出吻合器时吻合口有出血需用缝线结扎止血的有 13例 ,占 16 .3%。术后感觉疼痛者有 18例 ,占 2 2 .5 %。术后 2d病人均能下床活动 ,病人观察 2～ 5d出院。术中吻合器拔出后 ,大部分患者脱出的内痔、粘膜及皮赘立即回缩到肛管内 ,2～ 14d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 3年无复发和其它不良现象发生。结论 PPH治疗重度痔具有安全、有效、手术时间短、住院时间少。

Objective To discuss the value and operating skill of PPH method in the treatment of hemorrhoids. Methods 80 cases of hemorrhoids at the third or fourth degree were operated on by PPH. The operation effects were analysis and operation experiences were summarized. Results Operation time was 15～25 min and 20 min for average .When anastomose instruments were dropped out,the stoma were bleeding and needed ligate using suture to stop bleeding in 13 patients (16 3%). 18 patients (22 5%) feeled pain after opration. All patients took out of bed activary begin at the second day after operation and discharge after observed 2～5 days. Haemorrhoids started to rebound after operation,and hemorrhoidal mass were basically atrophy at 2～14 days. No patient was encopresis, anal stenosis infection or perianal abscess. No relapse and other bad phenomena were observed during 3 year's follow-up. Conclusions PPH is a safe and effective treatment for hemorrhoids at the third or fourth degree with the advantages of shorter hsopitaliztion time and quicker recovery.