混合痔及痔合并症中PPH手术的应用

目的:为探讨PPH手术在严重的混合痔及混合痔合并其他肛周疾病中的使用价值。方法:采用肛痔吻合器治疗严重的混合痔及混合痔合并肛瘘、肛裂、肛乳头瘤50例。结果:术后平均住院4d,术后疼痛需注射止痛剂5例,尿潴留经导尿后缓解6例。术后3周门诊复查无肛门狭窄、大便失禁、肛击感染等并发症,术后4周痊愈。结论:PPH手术具有安全可靠,疗效确切,值得临床推广。

混合痔及痔合并症中PPH手术的应用

目的:探讨PPH手术治疗混合痔及痔合并症的效果。方法:收治PPH术治疗的严重混合痔或痔合并症患者46例。结果:术后平均住院时间(4.87±1.43)d。术后30 d复查,所有患者吻合口均愈合良好,排便顺畅,未见并发症。结论:混合痔及痔合并症应用PPH手术治疗,取得了良好的治疗效果,且具有安全、可靠的特点。

PPH术与改良分段结扎术治疗环状混合痔的疗效分析

目的探讨PPH与改良分段结扎术治疗Ⅲ、Ⅳ度痔合并肛裂、肛乳头肥大、肛周皮赘、肛门狭窄的临床疗效。方法将108例具有肛门合并症的Ⅲ、Ⅳ度痔患者在知情同意后,随机分为PPH组54例,改良分段结扎组54例,比较两组术后疼痛、肛门水肿、手术费用、愈合时间、手术满意度、术后1个月、6个月肛门镜检结果,术后6个月、12个月随访结果。结果(1)术后8h视觉模拟疼痛(VAS)评分PPH组3.3(2～5),改良分段结扎组5.6(4～7),P<0.05,术后24h肛门静息时VAS评分,两组无差异,P>0.05,无统计学意义,术后24h排便疼痛(VAS)评分PPH组优于改良分段结扎组。(2)肛门水肿PPH组0例,改良分段结扎组4例,P<0.05。(3)愈合时间PPH组10～18d,改良分段结扎组15～25d,P<0.05。(4)手术费用PPH组(6120±238)元,改良分段结扎组(2830±180)元,P<0.05。(5)1个月、6个月两次肛镜检查PPH组在吻合口近或远侧有隆起增生的肛垫组织6例,改良分段结扎组1例,两组均无症状与不适。(6)满意度调查PPH组95%,改良分段结扎组92%,P>0.05。结论PPH术与改良分段结扎术两者均为有效治疗有肛门合并症的环状混合痔。术后疼痛、肛门水肿、愈合时间3个方面PPH术优于改良分段结扎术,手术费用少、远期并发症少、肛门外观平整是改良分段结扎术的优点。根据随访结果,PPH术后有明显改善便秘的症状,因此,对于内痔为主伴有便秘和肥胖的患者PPH术较好;外痔多于内痔、有陈旧性肛裂、肛门狭窄、肛乳头肥大等良性合并症的患者,改良分段结扎术较好。

Research progress of traditional Chinese medicine nursing techniques for the management of postoperative complications in mixed hemorrhoids

Mixed hemorrhoids,especially ring-shaped mixed hemorrhoid,is still a headache for anorectal surgeons due to its post-operative complications.In recent years,clinicians have been studying and exploring to avoid and alleviate these complications.In the Chinese medicine industry,the application of traditional Chinese medicine nursing technology has good and unique effect in prevent local pain,perianal edema,promote wound healing,relieve urinary retention,improve constipation,relieve anxiety,and so on.This article summarized the evidences of investigated the role of traditional Chinese medicine nursing technique in preventing and treating mixed hemorrhoid so that practitioners can make decision based on the best available evidences.