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排序方式: 共有595条查询结果,搜索用时 15 毫秒
1.
目的:探讨采用吻合器经肛管引流治疗重度痔降低术后并发症的影响。方法:随机将101例Ⅲ~Ⅳ期混合痔及内痔患者分为引流组48例和非引流组53例,回顾性分析两组施行PPH经肛引流及非引流术后的临床资料。结果:两组间数据比较伤口渗血(12h~48h)、排便异常指标,对照显示差异显著(P〈0.05)。结论:该术式具有安全、有效、术时短、恢复快及术后并发症明显降低等优点。 相似文献
2.
保留齿线悬吊术治疗环状混合痔 总被引:13,自引:1,他引:12
目的:探讨保留齿线悬吊术治疗环状混合痔的临床应用价值.方法:72例环状混合痔病人连续进入观察.随机分为两组:保留齿线悬吊术组(即治疗组36例)和外剥内扎法组(即对照组36例).根据治愈率、治愈时间及安全性方面的结果作评价.结果:保留齿线悬吊术组治愈率(88.89%)与对照组(83.33%)相比无显著性差异.治愈时间(18.42±4.67) d VS(22.11±6.01) d,两组有显著性差异;通过测定肛管直肠压力,显示两组手术均较安全.结论:保留齿线悬吊术治疗环状混合痔与外剥内扎术相比,明显缩短术后伤口愈合时间. 相似文献
3.
Pierpaolo Sileri Vito Maria Stolfi Giampiero Palmieri Alessandra Mele Alessandro Falchetti Sara Di Carlo Achille Lucio Gaspari 《Journal of gastrointestinal surgery》2007,11(12):1662-1668
Stapled hemorrhoidopexy is widely accepted to treat hemorrhoids, but serious complications have been reported. In this prospective
audit, we correlated clinical outcome with pathological findings. From January 2003 to April 2007, 94 patients underwent hemorrhoidopexy.
Macroscopic appearance of the specimen (shape, size, and depth) was recorded. Microscopically, the presence of columnar, transitional,
and squamous epithelium, the involvement of circular/longitudinal smooth muscle, and features of mucosal prolapse were assessed.
Clinical outcome was evaluated by a validated questionnaire. Postoperative pain, secretion, and bleeding durations were 12.7 +/− 10.6,
5.6 +/− 9.6, and 6.3 +/− 8.4 days. Patient’s return to work averaged 16.7 +/− 10.7 days. Fissure, skin tags, and anal strictures
were observed in 23.4%. Seven patients experienced pain for a significantly longer period of time. All specimens contained
columnar mucosa, but 29.8% contained columnar and transitional epithelium and 12.8% contained columnar, anal transitional,
and stratified squamous epithelium. Smooth muscle was observed in 62.7%. Pain was significantly increased if transitional
epithelium was present in the specimen. No correlation or differences were observed if smooth muscle was present, although
postoperative bleeding was more frequent. Hemorrhoidopexy is safe and effective. The specimen should always be sent for pathology
examination. Only columnar epithelium should be present and, although the presence of smooth muscle does not influence the
outcome in terms of functional results, its presence may play a role in postoperative bleeding.
Presented as poster at the Digestive Disease Week, May 2007, Washington, USA 相似文献
4.
Treatment of Hemorrhoids in Day Surgery: Stapled Hemorrhoidopexy vs Milligan–Morgan Hemorrhoidectomy
Vito Maria Stolfi Pierpaolo Sileri Chiara Micossi Isabella Carbonaro Marco Venza Paolo Gentileschi Piero Rossi Alessandro Falchetti Achille Gaspari 《Journal of gastrointestinal surgery》2008,12(5):795-801
Background Recently, it has been demonstrated that surgical treatment of hemorrhoids in a day-care basis is possible and safe. The aim
of this study was to compare the Longo stapled hemorrhoidopexy (SH) and the Milligan–Morgan hemorrhoidectomy (MMH).
Methods One hundred seventy one patients (95 cases in SH group and 76 cases in MMH group) entered the study: 83 cases were III degree
hemorrhoids, 88 IV degree. A priori and a post hoc power analysis were performed. Results, prospectively collected, were compared
using chi squared test and student t test. Visual analog scale was used for pain evaluation. Postoperative pain, duration of pain, wound secretion, bleeding,
resumption of a normal lifestyle, and postoperative complication were evaluated.
Results Surgical time was 28.41 ± 10.78 for MMH and 28.30 ± 13.28 min in SH (P = 0.94). Postoperative pain was not different between MMH and SH during the first two postoperative days (4.73 ± 2.91 vs
5.1 ± 3.048; P = 0.4), during the following 6 days, patients treated with SH had less pain (4.63 ± 2.04 in MMH vs 3.60 ± 2.35 in SH; P = 0.006). In the SH group, seven patients needed further hospital stay for complicated course. SH showed higher incidence
of anal fissure compared with MMH (6.3% vs 0%; P = 0.025) but no differences in urinary retention, anal stricture, urgency, or anal hemorrhage.
Conclusions This study confirms that SH is associated with less postoperative pain and shorter postoperative symptoms, compared with MMH.
SH may be a viable addition to the therapy for hemorrhoids with some advantages in early postoperative pain and some disadvantages
in postoperative complications and costs. 相似文献
5.
目的 通过观察人体内痔不同分期粘膜及血管内皮细胞生长因子(VEGF)及碱性成纤维细胞生长因子(FGF2)的表达,探讨内痔的发生及发展机制。 方法 收集南方医院肛肠科门诊手术切除的Ⅰ、Ⅱ、Ⅲ期内痔标本134例(Ⅰ期42例,Ⅱ期45例,Ⅲ期47例),内痔周围正常肠壁组织40例作为对照,采用HE染色观察组织的病理学变化,采用免疫组织化学方法检测血管内皮细胞VEGF及FGF2的表达。 结果 正常组及Ⅰ期内痔黏膜层被覆上皮完整,未见扩张血管;Ⅱ期内痔黏膜层被覆上皮破坏,黏膜肌层破坏,黏膜层内见新生血管;Ⅲ期内痔黏膜层被覆上皮破坏,见血管管壁增厚迂曲,管腔扩张;与正常粘膜成纤维细胞相比VEGF在粘膜层成纤维细胞表达水平明显升高,并随分期增高而增高(F=883.961,P<0.01),FGF2也存在相同表达(F=656.013,P<0.01);与正常组相比VEGF在血管内皮细胞表达水平明显升高,并随分期增高而增高(F=776.561,P<0.01),FGF2在血管内皮细胞的表达水平存在相同趋势(F=1066.458,P<0.01)。 结论 VEGF及FGF2在内痔的形成过程中具有促进血管内皮细胞和粘膜下成纤维细胞增生的作用,同时可作为内痔发生发展的分子标志物。 相似文献
6.
影响吻合器痔上黏膜环切术疗效的因素及改进方法 总被引:5,自引:1,他引:5
目的探讨影响吻合器痔上黏膜环切术(PPH)疗效的因素及改进方法。方法使用美国强生一次性PPH吻合器或国产PPH吻合器对68例痔病患者进行PPH手术,在手术改进前后分别对每例黏膜环切的标本以及症状的改善进行测量及观察。结果方法改进前,标本宽度为0.5~2.6cm,术后痔核回缩率75%;方法改进后,标本宽度为3.0~3.5cm,术后痔核回缩率100%。结论影响PPH手术疗效的因素主要是肛垫的提升复位与肛垫的固定。通过改进方法克服不利因素,使环切黏膜的宽度达到要求,进而使肛垫提升复位并得以固定,痔核回缩效果满意。 相似文献
7.
为观察内扎外剥保留齿状线加内痔注射术治疗混合痔的疗效,将600例混合痔患者随机分为A、B两组,每组各300例。A组采用内扎外剥保留齿状线加内痔注射术治疗,B组采用传统的外剥内扎术治疗。观察两组术后创口愈合时间、痔核结扎线脱落时间、疼痛程度、创缘水肿、肛周皮赘、肛门溢液、肛门舒适度及疗效。结果显示,两组各项指标均有显著性差异(P均〈0.05)。A组治愈率明显高于B组(93.3%vs 83.3%,P〈0.05)。结果表明,混合痔内扎外剥保留齿状线加内痔注射术疗效确切,创伤小,并发症少,操作简单,值得推广。 相似文献
8.
9.
10.
目的 评估经内镜痔上直肠黏膜套扎(super-hemorrhoidal banding,SHB)治疗内痔并脱出的安全性和有效性。方法 对2019年6月—2020年6月黔东南苗族侗族自治州人民医院收治的112例Ⅱ~Ⅲ度内痔患者进行SHB治疗。随访时间超过6个月。前瞻性观察SHB治疗内痔并脱出的疗效,术中、术后并发症及满意度。结果 共112例内痔患者接受SHB治疗,其中Ⅱ度74例(66.1%),Ⅲ度38例(33.9%)。患者手术均成功,术中无肛门疼痛、出血等症状。术后出现不同程度肛门坠胀感,持续2~24 h后症状消除。5例Ⅲ度内痔患者术后出现排尿困难,局部热敷刺激膀胱后得到改善;1例Ⅲ度内痔患者术后第14天便血,在出血溃疡处再次套扎治疗出血停止。患者均完成随访,术后1个月随访,均无出血、疼痛、感染、狭窄等并发症。18例Ⅲ度内痔患者术后仍有部分痔脱出,但无出血等其他症状,其中6例患者再次行SHB治疗后无痔脱出。全部患者完成术后6个月随访,无并发症发生,调查患者满意度为100.0%。结论 SHB是一种有效、安全、简便的内镜下治疗内痔合并脱出的方法。 相似文献