[1]侯松涛,张俊仲.不同手术方式治疗Ⅲ、Ⅳ度脱垂性混合痔的效果比较[J].医学信息,2021,34(18):113-115.[doi:10.3969/j.issn.1006-1959.2021.18.029]
 HOU Song-tao,ZHANG Jun-zhong.Comparison of the Effects of Different Surgical Methods in the Treatment of Grade Ⅲ and Grade Ⅳ Prolapsed Mixed Hemorrhoids[J].Medical Information,2021,34(18):113-115.[doi:10.3969/j.issn.1006-1959.2021.18.029]
点击复制

不同手术方式治疗Ⅲ、Ⅳ度脱垂性混合痔的效果比较()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年18期
页码:
113-115
栏目:
临床研究
出版日期:
2021-09-18

文章信息/Info

Title:
Comparison of the Effects of Different Surgical Methods in the Treatment of Grade Ⅲ and Grade Ⅳ Prolapsed Mixed Hemorrhoids
文章编号:
1006-1959(2021)18-0113-03
作者:
侯松涛张俊仲
天津市滨海新区中医医院肛肠科,天津 300451
Author(s):
HOU Song-taoZHANG Jun-zhong
Department of Anorectal,Tianjin Binhai New Area Traditional Chinese Medicine Hospital,Tianjin 300451,China
关键词:
脱垂性混合痔痔上黏膜C环切除术外剥内扎手术痔上黏膜环形切除钉合手术
Keywords:
Prolapsed mixed hemorrhoidsC-ring resection of the hemorrhoidsExternal stripping and internal ligationRing resection and nailing of the hemorrhoids
分类号:
R657.18
DOI:
10.3969/j.issn.1006-1959.2021.18.029
文献标志码:
A
摘要:
目的 比较外剥内扎手术、痔上黏膜C环切除手术和痔上黏膜环形切除钉合手术治疗Ⅲ、Ⅳ度脱垂性混合痔的疗效。方法选取2015年1月-2017年12月我院肛肠科收治的脱垂性混合痔患者435例作为研究对象,按照手术方式不同分为甲组185例、乙组152例和丙组98例,分别给予外剥内扎手术、痔上黏膜C环切除手术和痔上黏膜环形切除钉合手术治疗,比较三组临床疗效、围术期临床指标及预后情况。结果 甲组治疗总有效率低于乙组、丙组(P<0.05);而乙组、丙组治疗总有效率比较,差异无统计学意义(P>0.05)。甲组手术时间、住院天数长于乙组、丙组,手术满意度评分低于乙组、丙组,术后疼痛评分高于乙组、丙组(P<0.05);而乙组、丙组相关围术期指标比较,差异无统计学意义(P>0.05)。甲组疾病复发率、肛门狭窄发生率、术后出血率、再入院率均高于乙组、丙组(P<0.05);而乙组和丙组预后相关指标比较,差异无统计学意义(P>0.05)。结论 外剥内扎手术、痔上黏膜C环切除手术和痔上黏膜环形切除钉合手术三种术式均能有效治疗Ⅲ、Ⅳ度脱垂性混合痔,但相较而言,痔上黏膜C环切除手术和痔上黏膜环形切除钉合手术的临床疗效更为理想,术后并发症发生率更低,预后效果更好。
Abstract:
Objective To compare the clinical effects of external stripping and internal ligation, C-ring resection of the hemorrhoids, and circular resection and nailing of the hemorrhoids in the treatment of grade Ⅲ and grade Ⅳ prolapsed mixed hemorrhoids.Methods A total of 435 patients with prolapsed mixed hemorrhoids admitted to our hospital from January 2015 to December 2017 were selected as the research objects.According to the different surgical methods, they were divided into 185 cases in group A, 152 cases in group B, and 98 cases in group C. They were treated with external dissection and internal ligation, C-ring resection of the hemorrhoids,and ring resection and nailing of the hemorrhoids.The clinical efficacy, perioperative clinical indicators and prognosis of the three groups were compared.Results The total effective rate of treatment in group A was lower than that in groups B and C(P<0.05), while there was no statistically significant difference in the total effective rate of treatment between group B and group C (P>0.05).The operation time and length of hospital stay in group A were longer than those in groups B and C, the surgical satisfaction scores were lower than those in groups B and C, the postoperative pain scores were higher than those in groups B and C(P<0.05), while there was no statistically significant difference in related perioperative indicators between group B and group C (P>0.05).The disease recurrence rate, anal stenosis rate, postoperative bleeding rate, and readmission rate in group A were higher than those in groups B and C(P<0.05), while there was no statistically significant difference in prognostic indicators between groups B and C (P>0.05).Conclusion The three surgical methods of external stripping and internal ligation, C-ring resection of the hemorrhoids, and circular resection and nailing of the hemorrhoids can effectively treat grade Ⅲ and Ⅳ prolapsed mixed hemorrhoids.However, in comparison, the C-ring resection of the hemorrhoids and the circular resection and nailing of the hemorrhoids have better clinical effects.The incidence of postoperative complications is lower and the prognosis effect is better.

参考文献/References:

[1]张义,赵治江,连少雄,等.C形撑肛器在吻合器痔上黏膜切除钉合术治疗多点位脱垂痔的临床分析[J].临床外科杂志,2019,27(6):526-528.[2]陈振康.开环式选择性痔上黏膜切除术对脱垂性痔和混合痔的临床效果评价[J].中国实用医药,2015,10(19):98-99.[3]Nadri S,Mahmoudvand H,Rokrok S,et al.Comparison of Two Methods:Spinal Anesthesia and Ischiorectal Block on Post Hemorrhoidectomy Pain and Hospital Stay:A Randomized Control Trial[J].J Invest Surg,2018,31(5):420-424.[4]刘俊杰,蒋邦好,罗劲根.选择性痔上黏膜“C”形次环切术与PPH术治疗Ⅲ~Ⅳ度混合痔的临床效果分析[J].结直肠肛门外科,2019,25(6):72-75.[5]Carvajal López F,Hoyuela Alonso C,Juvany Gómez M,et al.Prospective Randomized Trial Comparing HAL-RAR Versus Excisional Hemorrhoidectomy:Postoperative Pain,Clinical Outcomes,and Quality of Life[J].Surg Innov,2019,26(3):328-336.[6]张玲,张秀岭,王淑妹,等.经肛三排钉吻合器配精细解剖电刀治疗重度混合痔与外剥内扎手术治疗对比的临床研究[J].中国性科学,2019,28(10):70-74.[7]刘超,王锐,王振彪,等.吻合器痔上黏膜环切术联合外剥内扎手术治疗Ⅲ-Ⅳ度环状混合痔的疗效及对患者肛门功能的影响[J].现代生物医学进展,2019,19(6):1083-1086,1118. [8]邓明,袁海涛.吻合器痔上黏膜环形切除术与外剥内扎手术治疗环状混合痔的效果及安全性差异[J].安徽医药,2016,12(1):150-151.[9]徐世文,朱国弈,邱振对,等.吻合器痔上黏膜环切术与外剥内扎手术治疗环状混合痔的临床效果及其对患者肛门功能的影响[J].临床合理用药杂志,2017,10(21):126-128.[10]程正理,邱顺英,黄玫芬.PPH手术与外剥内扎手术治疗环状混合痔效果对比[J].按摩与康复医学,2015,9(13):96-97.[11]杨俊川.改良吻合器痔上黏膜环形切除钉合术治疗环状混合痔的效果[J].河南医学研究,2020,29(12):2173-2174.[12]金龙,刘牧林.改良痔上黏膜环形切除钉合术治疗Ⅳ度痔200例临床分析[J].安徽医药,2019,23(2):333-336.[13]Jiang H,Hao X,Xin Y,et al.Comparison of clinical outcomes of multi-point umbrella suturing and single purse suturing with two-point traction after procedure for prolapse and hemorrhoids(PPH)surgery[J].Int J Surg,2017(47):77-82.

更新日期/Last Update: 1900-01-01