改良单荷包四点牵引法在PPH治疗环状混合痔中的临床效果观察

来源:用户上传      作者:林庆国 华国花 王天明 严万能

　　【摘要】 目的 观察改良单荷包四点牵引法吻合器痔上黏膜环切术（PPH）治疗环状混合痔的临床效果。方法 选取86例环状混合痔患者，分为改良组和常规组各43例，常规组采用常规单荷包单点牵引PPH治疗，改良组采用改良单荷包四点牵引PPH治疗，比较2组手术相关情况、临床疗效、视觉模拟评分法（VAS）评分、并发症和术后1年复发情况。结果 改良组的黏膜环宽度、黏膜环均匀率、痔核回缩率均高于常规组（P均< 0.05）。改良M治愈率98%，高于常规组的86%（P < 0.05）。2组术后VAS评分随时间延长而下降，其中改良组术后VAS评分下降比常规组更明显（P均< 0.05）。2组的术后出血、肛门狭窄及肛门坠胀等并发症发生率和术后1年复发率比较差异均无统计学意义（P均> 0.05）。结论 改良单荷包四点牵引法PPH治疗环状混合痔切除黏膜环更均匀，治愈率高且安全性良好。
　　【关键词】 单荷包四点牵引法;吻合器痔上黏膜环切术;环状混合痔;临床疗效
　　Clinical efficacy of modified single pouch four-point traction procedure for PPH in treatment of circular mixed hemorrhoids Lin Qingguo△， Hua Guohua， Wang Tianming， Yan Wanneng. △Department of General Surgery and Anorectal Surgery， Zhoushan Hospital of Zhejiang Province， Zhoushan 316000， China
　　Corresponding author， Yan Wanneng， E-mail： ywn4842@163.com
　　【Abstract】 Objective To observe the clinical efficacy of modified single pouch four-point traction procedure for prolapse and hemorrhoids （PPH） in the treatment of circular mixed hemorrhoids. Methods A total of 86 patients with circular mixed hemorrhoids were recruited and randomly divided into the experimental group （n = 43） and control group （n = 43）. In the control group， traditional single pouch single-point traction procedure for PPH was adopted， and modified single pouch four-point traction procedure for PPH was delivered in the experimental group. Surgical conditions， clinical efficacy， visual analogue scale （VAS） score， postoperative complications， and recurrence rate within postoperative one year were statistically compared between two groups. Results The width of the mucosal ring， the uniformity rate of the mucosal ring， and the retraction rate of hemorrhoids in the experimental group were significantly higher than those in the control group （all P < 0.05）. The cure rate in the experimental group was significantly higher than that of the control group （98% vs. 86%， P < 0.05）. In two groups， the VAS scores after surgery were significantly decreased over time， and the degree of decline in the experimental group was more pronounced than that in the control group （both P < 0.05）. The incidence of postoperative complications， such as postoperative bleeding， anal stenosis， and anal bulging， and the recurrence rate within postoperative one year did not significantly differ between two groups （all P > 0.05）. Conclusion The modified single pouch four-point traction procedure for PPH can resect the mucosal ring in a more uniform pattern， yield higher cure rate and better safety compared with traditional technique.
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