改良痔上粘膜环切钉合术操作方法防治术后并发症

目的 探讨痔上粘膜环切钉合术(PPH)并发症的预防与处理。方法 采用经改良的痔上粘膜环切钉合术治疗重度痔患者147例,分析其手术操作技巧与术后并发症的关联性。结果 术后所有脱出痔组织立即全部回缩,不同程度的腹胀不适、小便困难、疼痛、肛内坠胀便意感、火辣辣感是患者手术当天的主要痛苦所在,术后持续1~16d消失,36例术后第1~12d有间歇性便血,经保守治疗后消失。随访1~37个月无吻合口狭窄、肛门失禁及脱出复发。结论 改良PPH手术操作方法可以预防、减轻甚或消除术后各种并发症。

Modified procedure for prolapse and hemorrhoids to prevent and treat postoperative complications

Objective To investigate the complications of procedure for prolapse and hemorrhoids (PPH) and their management. Method The clinical data of 147 cases of severe hemorrhoids treated by modified PPH were analyzed in view of the operation method and postoperative complications. Result All the prolapsed hemorrhoids recovered immediately after the operation. The main complications on the first postoperative day were abdominal distention caused by dysuria, pain, and constant sense of defecation urgency, which lasted for 1 to 16 days. Thirty-six cases had intermittent hemafecia 1 to 12 days after operation, improved with expectant treatment. No stoma stenosis, copracrasia or relapse of prolapse occurred during the follow-up for 1 to 37 months. Conclusion All postoperative complications can be prevented, alleviated and cured with modified PPH.