摘要
目的探讨痔上黏膜环切钉合术（PPH）与用Ligasure血管闭合技术（LT）治疗痔的临床疗效。方法将86例Ⅲ度痔患者在知情同意后，随机分为PPH组（44例）和LT组（42例）。比较两组患者的手术时间、住院时间和术后疗效及出血、疼痛及费用。结果（1）手术时间：LT组为（12．0±4．1）min；PPH组为（19．0±6．4）min，差异有统计学意义（P〈0．05）。（2）疼痛：术后24h视觉模拟疼痛（VAS）评分PPH组和LT组分别为3．1（2．6）和5．4（3．8），差异有统计学意义（P〈0.05）。（3）费用：LT组为（4838±301）元，PPH组为（7796±492）元，差异有统计学意义（P〈0．05）。（4）并发症：PPH组术后出血（超过50ml）4例，复发1例；LT组无术后出血（1次量〉50ml）和复发。（5）满意度调查：术后6个月时，患者对手术疼痛、排便和总体满意度进行自我评分，PPH组分别为95．0％、100％和100％，LT组则分别为87．2％、97．4％和97．4％；两组差异无统计学意义（P〉0．05）。结论LT和PPH都是治疗痔的有效方法。LT与PPH比较，具有术中及术后几乎不出血、手术时间更短和费用更低的优点。但术后疼痛较为明显。
Objective To investigate and compare the clinical effects of procedure for prolapse and hemorrhoids （PPH） and Ligasure technique （LT） for the treatment of severe hemorrhoids. Methods Patients with prolapsed hemorrhoids were randomly divided into two groups treated with PPH （n=44） and LT （n=42）. The outcomes were evaluated postoperatively （i.e., operation time, length of hospital stay, pain intensity scoring, relapse of prolapse, bleeding and cost）. Results （l）The average operating time for patients treated by LT was （12.0±4.1） min, while for those by PPH was （19.0±6.4）min （P 〈 0.05）. （2）The average scores of visual analogue scale （VAS） for PPH and LT patients were 3.1 points （2～6） and 5.4 points （3～8） respectively （P 〈 0.05）. （3）The average costs for LT group and PPH group were （4838±301） yuan and （7796±492） yuan respectively （P 〈 0.05）. （4）In PPH group, 4 patients were complicated with hemorrhage （over 50 ml） and 1 patients with relapse, while there were no complications occurred in LT group. （5）Six months after operation, the self scores of postoperative pain,defecation and total satisfaction were 95.0%, 100% and 100% in PPH group, and 87.2%, 97.4% and 97.4% in LT group respectively. Conclusions Compared with PPH, LT has the advantages of shorter operation time, less hemorrhage and expense, but more postoperative pain. Both LT and PPH are effective procedures for severe hemorrhoids.
出处
《中华胃肠外科杂志》
CAS
2007年第4期342-345,共4页
Chinese Journal of Gastrointestinal Surgery
