吻合器痔上黏膜环切术治疗重度痔病的临床评价

目的探讨吻合器痔上黏膜环切术（PPH）治疗重度痔病的价值和手术技巧。方法用PPH方法治疗重度痔病患者120例，分析手术效果，总结手术经验。结果手术时间8～25min，平均13min，退出吻合器时吻合口有出血需用缝线结扎止血的有28例，占23．3％。术后感觉疼痛者有36例，占30％。术后2d病人均能下床活动，观察1～4d出院。术中吻合器退出后，大部分患者脱出的内痔、黏腱及皮赘立即回缩到肛管内，2～14d痔块基本完全萎缩。全组病人无1例发生大便失禁，肛门狭窄，感染或肛同脓肿形戍。随访1个月～2a无复发和其它不晟现象发生。结论PPH方法治疗重度痔病具有安全、有效、手术时间短、住院时间少、恢复快等优点。

Treatment Evaluation of severe hemorrhoids by PPH

[Objective] To discuss the value and operating skill of PPH method in the treatment of severe hemorrhoids. [Method] 60 cases of severe hemorrhoids at the third or fourth degree were operated on by PPH. The operation effects were analysis and operation experiences were summarized. [Results] Operation time was 8~25 min and 13 min for average. When anastomose instruments were dropped out, the stoma were bleeding and needed ligate using suture to stop bleeding in 28 patients (23.3%). 36 patients (30%) feeled pain after operation. All patients took out of bed activary begin at the second day after operation and discharge after observed 2~4 days. Hemorrhoids started to rebound after operation, and hemorrhoidal mass were basically atrophy at 2~14 days. No patient was encopresis, anal stenosis infection or perianal abscess. Norelapse and other bad phenomena were observed during 2 years follow up. [Conclusions] PPH is a safe and effective treatment for hemorrhoids at the third or fourth degree with the advantages of shorter hospitalization time and quicker recovery.