摘要
目的 观察保留齿状线分段结扎加皮瓣整形术治疗重度混合痔的临床疗效,为临床提供参考。方法 80例重度混合痔患者,随机分为治疗组和对照组,每组40例。对照组给予传统的外剥内扎术治疗,治疗组采用保留齿状线分段结扎加皮瓣整形术治疗。比较两组患者临床疗效,手术时间、住院时间,肛门疼痛评分,肛缘水肿评分,肛门出血情况,肛门坠胀程度;并分析两组患者术后复发情况。结果 两组患者的总有效率均为100.00%,组间比较差异无统计学意义(P>0.05)。两组患者的手术时间比较差异无统计学意义(P>0.05);治疗组患者的住院时间(4.8±0.8)d明显短于对照组的(9.2±0.2)d,差异具有统计学意义(P<0.05)。术后第14天,两组患者的肛门疼痛评分比较差异无统计学意义(P>0.05);术后第1、3、7天,治疗组患者的肛门疼痛评分分别为(4.45±1.23)、(2.52±0.91)、(1.66±0.65)分,均低于对照组的(5.10±1.10)、(3.50±1.58)、(2.05±1.02)分,差异有统计学意义(P<0.05)。术后第1、14天,两组患者的肛缘水肿评分比较,差异无统计学意义(P>0.05);术后第3、7天,治疗组患者的肛缘水肿评分分别为(1.45±0.60)、(1.28±0.62)分,均低于对照组的(1.85±0.72)、(1.59±0.73)分,差异有统计学意义(P<0.05)。术后第1天,两组患者肛门坠胀程度比较差异无统计学意义(P>0.05);术后第3、7、14天,治疗组患者肛门坠胀程度优于对照组,差异有统计学意义(P<0.05)。两组术后均随访6个月,电话回访均无出血、肛口有物突出,且无一例复发。结论 保留齿状线分段结扎加皮瓣整形术治疗重度混合痔是安全、经济、有效的一种手术方式,值得临床推广应用。
Objective To observe the clinical efficacy of segmental ligation with preserved dentate line and flap plastic surgery for severe mixed hemorrhoids, so as to provide reference for clinical practice.Methods A total of 80 patients with severe mixed hemorrhoids were randomly divided into a treatment group and a control group, with 40 cases in each group. The control group was treated by conventional milligan-morgan hemorrhoidectomy, while the treatment group was treated by segmental ligation with preserved dentate line and flap plastic surgery. Both groups were compared in terms of clinical efficacy, operation time, hospitalization time, anal pain score, anal margin edema score, anal bleeding, and degree of anal distension;the postoperative recurrence of the two groups was analyzed. Results The total effective rate of both groups was 100.00%, and the difference between the groups was not statistically significant(P>0.05). There was no statistically significant difference between the two groups in terms of operation time(P>0.05). The hospitalization time(4.8±0.8) d in the treatment group was significantly shorter than(9.2±0.2) d in the control group, and the difference was statistically significant(P<0.05). On postoperative days 1 and 14, there was no statistically significant difference in the anal pain scores between the two groups(P>0.05). On postoperative days 1, 3, and 7, the anal pain scores in the treatment group were(4.45±1.23),(2.52±0.91), and(1.66±0.65) points, which were lower than(5.10±1.10),(3.50±1.58), and(2.05±1.02) points in the control group, and the differences were statistically significant(P<0.05). On postoperative days 1 and 14, there was no statistically significant difference in anal margin edema score between the two groups(P>0.05). On postoperative days 3 and 7, the anal margin edema scores in the treatment group were(1.45±0.60) and(1.28±0.62) points, which were lower than(1.85±0.72) and(1.59±0.73) points in the control group, and the differences were statistically significant(P<0.05). On the 1st postoperative day, there was no statistically significant difference in the degree of anal distension between the two groups(P>0.05). On postoperative days 3, 7 and 14, the degree of anal distension in the treatment group was better than that in the control group, and the difference was statistically significant(P<0.05). Both groups were followed up for 6 months after surgery, and there was no bleeding or protruding anal orifice on telephone return visits, and there was no recurrence in any case. Conclusion Segmental ligation with preserved dentate line and flap plastic surgery is a safe, economical and effective surgical method for severe mixed hemorrhoids, which is worthy of clinical promotion and application.
作者
陆彩忠
常忠生
余肖
张军
LU Cai-zhong;CHANG Zhong-sheng;YU Xiao(Guangming Hospital of Traditional Chinese Medicine of Pudong New Area,Shanghai 201399,China)
出处
《中国现代药物应用》
2023年第3期6-11,共6页
Chinese Journal of Modern Drug Application
基金
上海市浦东新区科技发展基金事业单位民生科研专项项目(项目编号:PKJ2021-Y65)
上海市浦东新区“国家中医药发展综合改革试验区”建设项目(项目编号:PDZY-2022-0612)。
关键词
保留齿状线
分段结扎
皮瓣整形术
重度混合痔
Dentate line preservation
Segmental ligation
Flap plastic surgery
Severe mixed hemorrhoids
