吻合器痔上黏膜环切术并发症的处理

目的总结吻合器痔上黏膜环切术（PPH）并发症的处理经验，有效减少并发症的发生，以便提高疗效。方法选择2003年3月至2011年2月间在我院接受PPH手术治疗患者200例，对术中出血情况、术后出血情况、术后疼痛发生率、术后尿潴留发生率、术后吻合口炎发生率、有无肛门狭窄或失禁、术后随访1个月～7年有无复发等临床资料进行总结及临床分析。结果吻合口出血150例，其中渗血122例，搏动性出血28例，术后2例大出血（〉200ml），其余吻合口出血少（〈30ml），术后发生尿潴留56例（28％），术后疼痛较剧烈12例（6％），术后吻合口炎10例（5％），无肛门狭窄或失禁，术后随访1个月～7年再发脱垂1例。结论PPH手术并发症值得重视，需积极预防及有效处理。

Management of complications of procedure for prolapse and hemorrhoids

Objective To summarize the management experiences on complications of procedure for prolapse and hemorrhoids （PPH） and decrease the rate of complication related to the surgical in order to improve efficacy. Methods Two hundred cases of hemorrhoids received surgical treatment by PPH from March 2003 to February 2011 in our hospital, their operative bleeding, postoperative bleeding, postoperative pain incidence, urinary retention recurrence, anastomotic inflammation incidence and with or without fecal incontinence and anal striture of patients were followed - up for one month to 7 years and other clinical datas were summarized and analyzed. Results Anastomotic bleeding occurred in 150 cases, including angiorrhea in 122 cases and pulsating bleeding in 28 cases, with 2 cases of anastomotic hemorrhage（ 〉 200 ml） , others with less bleeding（ 〈 30 ml） , post - operative urinary retention in 30 cases（25 % ） , severe postoperative pain compared with 6 cases（5% ） , anastomotic inflammation in 10 cases （5%） , no fecal incontinence, no anal striture, patients were followed - up for one month to 2 years with only one case recurrence. Conclusions We should think highly of the complication of PPH surgery and strenthen the prevention and cure of the preoperative and postoperative complications.