痔上粘膜环切钉合术后脱出的危险因素分析

目的分析痔上粘膜环切钉合术(PPH)后痔复发脱出的危险因素。方法回顾性分析2005-01/2012-02的178例PPH患者临床资料。结果本组患者随访时间2～87月,术后复发脱出48例(26.97%)。Ⅳ度内痔患者复发脱出率(45.16%)明显高于Ⅱ、Ⅲ度内痔患者;术后时间3年者脱出发生率(41.46%)明显高于≤3年者(14.58%),差异有统计学意义(P0.05)。性别、年龄、有无合并直肠粘膜脱垂及慢性便秘、单双荷包缝合、荷包距齿状线距离、吻合口距齿状线距离的脱出发生率间的差异无统计学意义(P0.05)。Logistic回归分析提示术后时间、痔分度、吻合口距齿状线距离是复发脱出的危险因素。结论术后时间、痔分度是PPH后痔复发脱出的独立危险因素。

Risk Factors of Prolapse After Procedure for Prolapse and Hemorrhoids

Objective To analyze the risk factors of prolapse after procedure of prolapse and hemorrhoids(PPH) for haemorrhoids.Methods The clinical data of 178 severe haemorrhoids patients underwent PPH from January 2005 to February 2012 were reviewed and analyzed.Results Patients were followed-up through a period of 2-87 months.The overall rate of postoperative prolapse was 26.97%(48 of 178 patients).The rate of prolapse was significantly higher for patients with fourth-degree hemorrhoids than those with second-degree or third-degree hemorrhoids(45.16% versus 11.76% or 24.62%,P<0.05).The rate of prolapse was significantly higher for postoperative time more than 3 years than those less than 3 years(41.46% versus 14.58%,P<0.05).There were no statistical differences among prolapse rates for gender,age,proctoptosis,constipation,single or double purse string suture,distance of the purse from dentate line and distance of the anastomotic stoma from dentate line.Logistic regression analysis of the data showed that the length of postoperative time,the degree of hemorrhoids and the distance of the anastomotic stoma from dentate line were the risk factors for development of prolapse.Conclusion The length of postoperative time and the degree of hemorrhoids were the independent risk factors for development of prolapse after PPH for severe cases.