TST术与PPH术治疗痔病的临床对比研究

目的：比较选择性痔上黏膜切除吻合术（TST术）与吻合器痔上黏膜环切术（PPH术）治疗痔病的临床效果。方法：将492例痔病患者随机分为两组,实验组采用TST术治疗,对照组采用PPH术治疗。对比观察两组患者的手术治愈率,术后疼痛、肛门水肿、尿潴留、出血、肛门坠胀、吻合口狭窄等并发症的发生情况。结果：实验组术后疼痛、尿潴留、出血、肛门坠胀、吻合口狭窄等并发症的发生与对照组比较,差异有统计学意义（P〈0.05）,但术后肛门水肿情况两组差异无统计学意义（P〉0.05）;两组的手术治愈率比较差异无统计学意义（P〉0.05）。结论：TST术治疗Ⅲ~Ⅳ度痔病的疗效与PPH术相似,但TST术术后并发症少,创伤小,手术安全、有效、微创,是符合肛门直肠生理的治疗痔病的新技术。

Comparative Research of Tissue-selecting Therapy and Precedure for Prolapse and Hemorrhoids on Treating Hemorrhoids

Objective： To Compare the therapeutic efficacies of tissue-selecting therapy（ TST） and procedure for prolapse and hemorrhoids（ PPH） in the treatment of hemorrhoids. Methods： This study consisted of 492 patients with hemorrhoids,who were evenly randomized to TST（ experimental group） and PPH（ controlled group）. A comparison was done between the two groups in terms of the following items： operation cure rate and the postoperative complications including significant anal pain,anal edema,retention of urine,bleeding,anus bulge and anal stenosis. Results： The differences between TST and PPH groups were significant in terms of the postoperative complications including significant anal pain,retention of urine,bleeding,anus bulge and anal stenosis（ P 0. 05）,and no significant differences were noted in terms of anal edema and the operation cure rate（ P 0. 05）. Conclusion： The therapeutic efficacy of TST and PPH for degree Ⅲ ~ Ⅳ hemorrhoids is similar,but TST has more advantages than PPH of less postoperative complications and less trauma. TST is safe,effective,and mini-invasive,which is a new technique that consistent with recto-anal physiology.