关键词: 痔动脉结扎, 超声刀, 缚扎悬吊术, 环状脱垂性混合痔, 临床疗效

Abstract: Objective To investigate the clinical effect of hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligature and suspension in the treatment of mixed hemorrhoids with annular prolapse.Methods A retrospective analysis was conducted to select 80 patients with annular prolapse mixed hemorrhoids admitted to the anorectal Department of our hospital from January 2022 to April 2023.According to different treatment plans,they were divided into control group(n=40 cases) who received external stripping and internal ligation combined with tape ligation,and study group(n=40 cases) who received hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligation and suspension.The operative effect,operative status,postoperative anal pain,anal edema,stool blood score and quality of life were evaluated.Results The effective rate of the study group was 97.50%,which was higher than that of the control group(77.50%)(P＜0.05).The operation time, intraoperative blood loss, hospital stay and wound healing time of the research group were (25.03±10.00) minutes, (10.00±5.32)ml, (7.25±1.54) days and (12.21±2.00) days respectively. [is better than that of control group (29.85±14.00) minutes, ml (17.85±10.25), (11.87±2.35), (18.89±4.85) days], two groups of comparison, the difference was statistically significant (P< 0.05 ).The VAS scores of anal pain in the study group on 1 day, 3 days and 7 days after the operation were (4.25±0.85) points, (2.89±0.54) points and (2.00±0.30) points,respectively.The scores of perianal edema were (1.87±0.36) points, (1.41±0.30) points, and (1.00±0.20) points,respectively.The hematochezia scores were (1.85±0.21) points, (1.34±0.18) points, and (0.85±0.13) points,respectively.Which were better than that of control group [(7.56±1.10), (6.54±1.03), (4.87±1.00)] [(2.40±0.58), (2.03±0.49), (1.87±0.45)] [(2.45±0.55), (2.03±0.47),(1.88±0.25)], and the differences were statistically significant (P < 0.05).The recurrence rate was 2.50% in the study group and 17.50% in the control group(P＜0.05).The scores of SF,MH,PF and GH of the Modified Health Survey Summary Form(SF-36) in the study group were(88.54±10.22,87.87±10.58,88.97±10.00,89.95±10.05) higher than those of the control group(67.52±10.00,70.10±11.25,71.10±9.85,70.00±10.00)(P＜0.05).Conclusion Hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligature and suspension in the treatment of patients with annular prolapse mixed hemorrhoids has ideal surgical effect and little trauma,which is beneficial to promoting postoperative rehabilitation,alleviating anal pain,improving anal edema and hematostoecium,and improving quality of life.

Key words: hemorrhoidal artery ligation, ultrasonic knife, tethered suspension, circumferential prolapsed mixed hemorrhoids, clinical efficacy