摘要
目的重度混合痔临床治疗主要采取手术切除法,其中包括吻合器痔上黏膜环切术(procedure for prolapse and haemorrhoids,PPH)和外剥内扎术(milligan-morgan hemorrhoids,MMH)。自动弹力线痔套扎术(ruiyun procedure for hemorrhoids,RPH)近年来逐步应用于临床。本研究探讨MMH联合RPH治疗混合痔的临床效果。方法选取2016-05-01-2018-05-01新密市中医院收治的124例重度混合痔患者作为研究对象。依据组间性别、年龄和病程等因素具有可比性的原则,选择观察组和对照组,各62例。对照组采用PPH治疗。观察组采取MMH联合RPH治疗。观察两组患者手术指标、临床疗效和并发症发生情况。结果观察组手术时间为(18.74±4.11)min,与对照组的(20.26±4.87)min比较,差异无统计学意义,t=-2.012,P=0.098。观察组术中出血量为(7.37±3.52)mL,低于对照组的(26.35±5.11)mL,t=-42.457,P<0.001;术后住院时间为(5.28±1.04)d,短于对照组的(10.67±2.54)d,t=-40.809,P<0.001;创面愈合时间为(18.58±3.86)d,低于对照组的(21.75±5.11)d,t=-6.466,P=0.048。两组总有效率均为100.00%,差异无统计学意义,χ^2=0.000,P=1.000。观察组并发症总发生率为3.23%,低于对照组的19.35%,差异有统计学意义,χ^2=8.052,P=0.005。结论采取MMH联合RPH治疗重度混合痔患者,可以减少术中出血量、缩短住院时间和创面愈合时间。
OBJECTIVE Severe mixed hemorrhoids are mainly treated by surgical excision,including procedure for prolapse and haemorrhoids(PPH)and Milligan-Morgan hemorrhoids(MMH).Ruiyun procedure for hemorrhoids(RPH)has been gradually applied in clinical practice in recent years.This study was to investigate the clinical effect of MMH combined with RPH in the treatment of mixed hemorrhoids.METHODS A total of 124 patients with severe mixed hemorrhoids who were treated in Xinmi City Hospital from May 1,2016 to May 1,2018 were selected as subjects.According to the principle of comparability,such as gender,age,and duration of disease,62 patients were selected from the observation group and the control group.The control group was treated with PPH.The observation group was treated with MMH combined with RPH.The surgical indexes,clinical efficacy and complications of the two groups were observed.RESULTS The operation time of the observation group(18.74±4.11)min was compared with the control group(20.26±4.87)min,and the difference was not statistically significant,t=-2.012,P=0.098.The intraoperative blood loss was(7.37±3.52)ml in the observation group,which was lower than that in the control group(26.35±5.11)ml,t=-42.457,P<0.001.The postoperative hospital stay was(5.28±1.04)d,which was shorter than that of the control group(10.67±2.54)d,t=-40.809,P<0.001.The wound healing time was(18.58±3.86)d,which was lower than that of the control group(21.75±5.11)d,t=-6.466,P=0.048.The total effective rates of the two groups were both100.00%,and the difference was not statistically significant,χ^2=0.000,P=1.000.The total incidence of complications in the observation group was 3.23%,which was lower than that in the control group(19.35%).The difference was statistically significant,χ^2=8.052,P=0.005.CONCLUSION MMH combined with RPH in the treatment of patients with severe mixed hemorrhoids can reduce the amount of intraoperative blood loss,shorten the length of hospital stay and wound healing time.
作者
吕小红
司志伟
LU Xiao-hong;SI Zhi-wei(Department of Proctology,Xinmi Hospital of Traditional Chinese Medicine,Xinmi 452370,P.R.China)
出处
《社区医学杂志》
2019年第22期1429-1432,共4页
Journal Of Community Medicine
关键词
外剥内扎术
自动弹力线痔套扎术
黏膜环切术
混合痔
重度
external stripping and internal ligation
automatic elastic thread hemorrhoid ligation
procedure for prolapse and haemorrhoids
mixed hemorrhoid
