BACKGROUND The pathogenesis of hemorrhoids is mainly anal cushion prolapse.Although the traditional treatment has a certain curative effect,it is not ideal.The remission rate of postoperative symptoms is low.Even if t...BACKGROUND The pathogenesis of hemorrhoids is mainly anal cushion prolapse.Although the traditional treatment has a certain curative effect,it is not ideal.The remission rate of postoperative symptoms is low.Even if temporary remission is achieved,patients with hemorrhoids easily relapse after 1-2 years.The new technique of using staplers to treat prolapsed hemorrhoids has good therapeutic effects in clinical practice.AIM To explore the effect of TST33 mega stapler prolapse and hemorrhoid mucosal resection in the treatment of patients with severe prolapsed hemorrhoids.METHODS A total of 204 patients with severe prolapse hemorrhoids who were admitted to the department of anorectal in our hospital from April 2018 to June 2020 were selected,and the patients were randomly divided into group A and group B with 102 cases in each group using a randomized controlled clinical research program.Patients in Group A were treated with a TST33 mega stapler and hemorrhoid mucosal resection to treat prolapse,and patients in Group B were treated according to the Procedure for Prolapse and Hemorrhoids;the operation time,intraoperative blood loss,hospital stay,the difference in operation time,intraoperative blood loss,hospitalization time,pain degree before and after operation,degree of anal edema,anal Wexner score,and surgical complications were compared between the two groups of patients.RESULTS The operation time,intraoperative blood loss and hospitalization time in Group A were significantly lower than those in Group B(P<0.05).The cure rate of Group A was 98.04%,compared with 95.10%cure rate of Group B,and the difference was not statistically significant(P>0.05).The visual analogue scale(VAS)at 12 h and 24 h postoperatively in Group A were significantly lower than those in Group B(P<0.05).The comparison of the VAS scores between Group A and Group B at 48 h,72 h and 96 h postoperatively revealed that the difference was not statistically significant(P>0.05).One day postoperatively,the degree of perianal edema in Group A was compared with that in Group B,and the difference was not statistically significant(P>0.05).Seven days postoperatively,the degree of perianal edema in Group A was significantly lower than that in Group B(P<0.05).The comparison of anal Wexner scores between the two groups preoperatively and at 1 mo,3 mo and 6 mo postoperatively showed that the difference was not statistically significant(P>0.05).The Wexner scores of the two groups at 1 mo,3 mo and 6 mo postoperatively were significantly lower than the scores preoperatively(P<0.05).The postoperative complication rate of Group A was 2.94%lower than that of Group B(11.76%),which was statistically significant(P<0.05).CONCLUSION TST33 mega anastomotic hemorrhoidectomy treatment for patients with severe prolapse hemorrhoids,leads to less postoperative pain,the rapid recovery of perianal edema and has fewer complications.展开更多
目的观察外剥内扎术结合残余痔组织剥除、痔上黏膜套扎术(M-M procedure,excision of residual piles tissue and above mucosa ligation,MEAL)治疗环状混合痔的临床疗效。方法收集2019年1月至2020年1月于南京中医药大学第二附属医院肛...目的观察外剥内扎术结合残余痔组织剥除、痔上黏膜套扎术(M-M procedure,excision of residual piles tissue and above mucosa ligation,MEAL)治疗环状混合痔的临床疗效。方法收集2019年1月至2020年1月于南京中医药大学第二附属医院肛肠中心接受MEAL的54例环状混合痔病人作为实验组(MEAL组);以同期47例行单纯外剥内扎术(M-M组)和36例行选择性痔上黏膜切除术(TST组)的病人为对照组,分别比较各组病人的住院时间、创面愈合时间、皮赘残留、痔疮复发、肛门狭窄及肛门失禁情况。结果随访时间为(351.80±110.28)d,MEAL组的住院时间和对照组比较,差异无统计学意义(均P>0.05);MEAL组的创面愈合时间(11.55±1.67)d短于M-M组(12.38±1.91)d及TST组(12.38±2.11)d,均差异有统计学意义(均P<0.05);MEAL组的痔疮复发率1.85%(1/54)、皮赘残留发生率18.52%(10/54)均低于M-M组痔疮复发率14.89%(7/47)、皮赘残留发生率36.17%(17/47)及TST组痔疮复发率16.66%(6/36)、皮赘残留发生率41.67%(15/36),差异有统计学意义(均P<0.05);全组均无肛门失禁及肛门狭窄病例。结论基于M-M的MEAL治疗环状混合痔具有减少创面、降低复发率等优点,在保护肛门的同时,明显减少了皮赘残留的发生。展开更多
目的:评价痔上黏膜环切术(procedure for prolapse and hemorrhoids,PPH)的临床意义。方法:对42例环状混合痔行PPH手术。结果:术后肛门口平整无水肿,排便后未见痔核脱出及肛门异物感,无肛管缩小和肛门狭窄。结论:环状混合痔采取PPH疗效...目的:评价痔上黏膜环切术(procedure for prolapse and hemorrhoids,PPH)的临床意义。方法:对42例环状混合痔行PPH手术。结果:术后肛门口平整无水肿,排便后未见痔核脱出及肛门异物感,无肛管缩小和肛门狭窄。结论:环状混合痔采取PPH疗效满意,较传统手术恢复快、无痛、术后并发症少三大临床优势,切实可行。展开更多
目的:研究中药熏洗方结合通理汤治疗痔疮吻合器痔环切手术(Procedure for Prolapse and Hemorrhoids,PPH)术后并发症的临床疗效。方法:选取2018年4-11月在我院进行相关手术治疗的40例痔疮患者,对照组采用常规西药灌肠并进行熏洗,观察组...目的:研究中药熏洗方结合通理汤治疗痔疮吻合器痔环切手术(Procedure for Prolapse and Hemorrhoids,PPH)术后并发症的临床疗效。方法:选取2018年4-11月在我院进行相关手术治疗的40例痔疮患者,对照组采用常规西药灌肠并进行熏洗,观察组采取中药熏洗以及通理汤进行联合治疗,经过不同方法处理之后对两组患者临床疗效以及相关炎症因子等指标进行临床专业对比。结果:观察组经过中药熏洗方结合通理汤治疗之后,临床疗效以及相关炎症因子等指标改善情况明显优于对照组,P<0.05。结论:当患者进行PPH之后采用中药熏洗方结合通理汤进行联合治疗能够显著提高临床疗效,同时能够改善相关炎症因子,因此该方法适用于临床推广。展开更多
基金Supported by Special Project of Diagnosis and Treatment Technology for Key Clinical Diseases in Suzhou,No.LCZX202022Changshu Municipal Science and Technology Bureau Supporting Project,No.CS201925。
文摘BACKGROUND The pathogenesis of hemorrhoids is mainly anal cushion prolapse.Although the traditional treatment has a certain curative effect,it is not ideal.The remission rate of postoperative symptoms is low.Even if temporary remission is achieved,patients with hemorrhoids easily relapse after 1-2 years.The new technique of using staplers to treat prolapsed hemorrhoids has good therapeutic effects in clinical practice.AIM To explore the effect of TST33 mega stapler prolapse and hemorrhoid mucosal resection in the treatment of patients with severe prolapsed hemorrhoids.METHODS A total of 204 patients with severe prolapse hemorrhoids who were admitted to the department of anorectal in our hospital from April 2018 to June 2020 were selected,and the patients were randomly divided into group A and group B with 102 cases in each group using a randomized controlled clinical research program.Patients in Group A were treated with a TST33 mega stapler and hemorrhoid mucosal resection to treat prolapse,and patients in Group B were treated according to the Procedure for Prolapse and Hemorrhoids;the operation time,intraoperative blood loss,hospital stay,the difference in operation time,intraoperative blood loss,hospitalization time,pain degree before and after operation,degree of anal edema,anal Wexner score,and surgical complications were compared between the two groups of patients.RESULTS The operation time,intraoperative blood loss and hospitalization time in Group A were significantly lower than those in Group B(P<0.05).The cure rate of Group A was 98.04%,compared with 95.10%cure rate of Group B,and the difference was not statistically significant(P>0.05).The visual analogue scale(VAS)at 12 h and 24 h postoperatively in Group A were significantly lower than those in Group B(P<0.05).The comparison of the VAS scores between Group A and Group B at 48 h,72 h and 96 h postoperatively revealed that the difference was not statistically significant(P>0.05).One day postoperatively,the degree of perianal edema in Group A was compared with that in Group B,and the difference was not statistically significant(P>0.05).Seven days postoperatively,the degree of perianal edema in Group A was significantly lower than that in Group B(P<0.05).The comparison of anal Wexner scores between the two groups preoperatively and at 1 mo,3 mo and 6 mo postoperatively showed that the difference was not statistically significant(P>0.05).The Wexner scores of the two groups at 1 mo,3 mo and 6 mo postoperatively were significantly lower than the scores preoperatively(P<0.05).The postoperative complication rate of Group A was 2.94%lower than that of Group B(11.76%),which was statistically significant(P<0.05).CONCLUSION TST33 mega anastomotic hemorrhoidectomy treatment for patients with severe prolapse hemorrhoids,leads to less postoperative pain,the rapid recovery of perianal edema and has fewer complications.
文摘目的观察外剥内扎术结合残余痔组织剥除、痔上黏膜套扎术(M-M procedure,excision of residual piles tissue and above mucosa ligation,MEAL)治疗环状混合痔的临床疗效。方法收集2019年1月至2020年1月于南京中医药大学第二附属医院肛肠中心接受MEAL的54例环状混合痔病人作为实验组(MEAL组);以同期47例行单纯外剥内扎术(M-M组)和36例行选择性痔上黏膜切除术(TST组)的病人为对照组,分别比较各组病人的住院时间、创面愈合时间、皮赘残留、痔疮复发、肛门狭窄及肛门失禁情况。结果随访时间为(351.80±110.28)d,MEAL组的住院时间和对照组比较,差异无统计学意义(均P>0.05);MEAL组的创面愈合时间(11.55±1.67)d短于M-M组(12.38±1.91)d及TST组(12.38±2.11)d,均差异有统计学意义(均P<0.05);MEAL组的痔疮复发率1.85%(1/54)、皮赘残留发生率18.52%(10/54)均低于M-M组痔疮复发率14.89%(7/47)、皮赘残留发生率36.17%(17/47)及TST组痔疮复发率16.66%(6/36)、皮赘残留发生率41.67%(15/36),差异有统计学意义(均P<0.05);全组均无肛门失禁及肛门狭窄病例。结论基于M-M的MEAL治疗环状混合痔具有减少创面、降低复发率等优点,在保护肛门的同时,明显减少了皮赘残留的发生。
文摘目的:评价痔上黏膜环切术(procedure for prolapse and hemorrhoids,PPH)的临床意义。方法:对42例环状混合痔行PPH手术。结果:术后肛门口平整无水肿,排便后未见痔核脱出及肛门异物感,无肛管缩小和肛门狭窄。结论:环状混合痔采取PPH疗效满意,较传统手术恢复快、无痛、术后并发症少三大临床优势,切实可行。
文摘目的:研究中药熏洗方结合通理汤治疗痔疮吻合器痔环切手术(Procedure for Prolapse and Hemorrhoids,PPH)术后并发症的临床疗效。方法:选取2018年4-11月在我院进行相关手术治疗的40例痔疮患者,对照组采用常规西药灌肠并进行熏洗,观察组采取中药熏洗以及通理汤进行联合治疗,经过不同方法处理之后对两组患者临床疗效以及相关炎症因子等指标进行临床专业对比。结果:观察组经过中药熏洗方结合通理汤治疗之后,临床疗效以及相关炎症因子等指标改善情况明显优于对照组,P<0.05。结论:当患者进行PPH之后采用中药熏洗方结合通理汤进行联合治疗能够显著提高临床疗效,同时能够改善相关炎症因子,因此该方法适用于临床推广。
