临床外科杂志 ›› 2023, Vol. 31 ›› Issue (9): 873-876.doi: 10.3969/j.issn.1005-6483.2023.09.021

• 论著 • 上一篇    下一篇

主动选择拉力吻合在吻合器痔上黏膜环切术治疗重度痔的疗效评价

  

  1. 528400 广东省中山市人民医院肛肠科
  • 收稿日期:2023-03-02 出版日期:2023-09-20 发布日期:2023-09-20
  • 通讯作者: 刘勇敢,Email:lyg650818@163.com

Effectiveness of actively select the pull force anastomosis for procedurefor prolapse and hemorrhoids in treating severe hemorrhoids

  1. Department of Anorectal Surgery,Zhongshan City People’s Hospital,Zhongshan 528400,China
  • Received:2023-03-02 Online:2023-09-20 Published:2023-09-20

摘要: 目的 探讨吻合器痔上黏膜环切术(PPH)中主动选择拉力吻合治疗重度痔的临床效果。方法 2020年1月~2023年1月收治的重度痔病人92例,按治疗方法分为对照组与研究组,每组各46例。对照组常规行PPH手术;研究组PPH术中主动选择拉力吻合位置。比较两组的手术情况、临床疗效、术后并发症的差异。结果 两组病人住院时间、术中出血量、术后出血、术后肛门异常情况比较,差异无统计学意义(P>0.05);研究组手术时间(25.8±6.4)分钟,术中黏膜下血肿发生率为2.17%,黏膜切除宽度为(3.4±0.46)cm,黏膜环完整性为100%,Ⅲ度和Ⅳ度痔痔核回缩率分别为 (96.77%、88.67%),均优于对照组,差异有统计学意义(P<0.05),研究组的术后24小时、48小时、1周的VAS评分低于对照组,差异有统计学意义(P<0.05)。结论 PPH术中主动选择拉力吻合治疗重度痔效果良好,肛垫提拉效果满意、痔核回缩率高、黏膜下血肿发生少、术后疼痛感轻。

关键词: 主动选择拉力吻合, 吻合器痔上黏膜环切术, 重度痔

Abstract: Objectives To investigate the effectiveness of actively select the pull force anastomosis for procedure for prolapse and hemorrhoids (PPH) in treating severe hemorrhoids. Methods We retrospectively analyzed 92 patients with severe hemorrhoids treated by author,between January 2020 and January 2023.The 92 cases were randomly divided into control group and observationgroup,with 46 cases each group.The control group was treated with regular PPH,while the observation group was treated with actively select the pull force anastomosis for PPH.We compared the surgical parameters,clinical effectiveness,postoperative complications in the two groups.Results There was no significant difference in length of hospital stay,intraoperative hemorrhage,postoperative bleeding,postoperative anorectal sensation abnormalities(P>0.05).The operation time(25.8±6.4)min,intraoperative submucosal hematoma 2.17%,the width and integrity of rectal mucosa (3.4±0.46) cm,the retraction of hemorrhoids with grade Ⅲ and grade Ⅳ(96.77%、88.67%) in the observation group were better than control group(P<0.05).The pain scores of the observation group at 24h,48h,7 day was significantly lower than that of the control group(P<0.05). Conclusion Actively select the pull force anastomosis for PPH has favorable effectiveness for severe hemorrhoids.The effect of anal cushion lifting was satisfactory,the retraction rate of hemorrhoids was high,the occurrence of submucosal hematomas was small,and the postoperative pain was light.

Key words: actively select the pull force anastomosis, procedure for prolapse and hemorrhoids, severe hemorrhoids

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