吻合器痔上黏膜C形切除钉合术治疗环状脱垂痔的临床观察

目的探讨吻合器痔上黏膜C形切除钉合术（TCT）在治疗环状脱垂痔的临床应用价值。 方法回顾分析黄冈市中医医院肛肠科自2015年6月至2016年6月共收治116例环状脱垂痔的临床资料，随机分组：实验组采用TCT（TCT组，60例），对照组采用常规PPH（PPH组，56例），两组患者均采用同型号一次性肛肠吻合器，TCT组使用本科设计C形术式撑肛器，对照组使用常规的PPH组件。将两组患者在一般临床资料、术中及术后各方面情况进行分析对比。 结果TCT组的手术时间（20.1±6.3 min）少于PPH组（25.2±6.9 min），差异有统计学意义（t=2.10，P=0.004）；TCT组的术中出血量（6.5±1.2 ml）少于PPH组（13.6±2.6 ml），差异有统计学意义（t=2.21，P=0.001）；TCT组的疼痛持续时间（1.5±0.4 h）短于PPH组（5.0±0.6 h），差异有统计学意义（t=2.05，P=0.000）；TCT组的住院时间（6.1±0.6 d）少于PPH组（6.9±0.5 d），差异有统计学意义（t=1.78，P=0.002）；TCT组的吻合口继发大出血（0%）少于PPH组（8.9%），差异有统计学意义（P=0.010）；TCT组的吻合口狭窄（0%）少于PPH组为（8.9%），差异有统计学意义（P=0.010）；TCT组的肛门坠胀（1.7%）少于PPH组（14.3%），差异有统计学意义（P=0.014）；TCT组的尿潴留（5%）少于PPH组（21.4%），差异有统计学意义（P=0.011）。 结论TCT组在手术时间、术中出血量、疼痛持续时间、住院时间、吻合口继发大出血、吻合口狭窄、肛门坠胀、尿潴留等情况要优于常规PPH组，对环状脱垂痔的治疗，可以采用TCT代替PPH，值得临床推广应用。

Clinical observation of the treatment of annular prolapse hemorrhoid by type-C therapy stapler

ObjectiveTo explore the clinical application value of type-C therapy stapler (TCT) in the treatment of annular prolapse hemorrhoids. MethodsThe clinical data of 116 cases of annular prolapse hemorrhoids were collected from June 2015 to June 2016 in Traditional Chinese Medicine Hospital of Huanggang. The patients were randomly divided into two groups: The experimental group was treated with TCT (TCT group, 60 cases), The control group was treated with conventional PPH (56 cases in PPH group), TCT group using our design C-type surgery to hold the anal device, the control group using conventional PPH components. The two groups of patients in the general clinical data, surgery and postoperative aspects of the situation were analyzed and compared. ResultsThe operation time in the TCT group (20.1±6.3 min) was less than that in the PPH group (25.2±6.9 min), the difference was statistically significant (t=2.10, P=0.004). The intraoperative blood loss in the TCT group (6.5±1.2 ml) was less than that in the PPH group (13.6±2.6 ml), the difference was statistically significant (t=2.21, P= 0.001). The duration of pain in the TCT group (1.5±0.4 h) was shorter than that in the PPH group (5.0±0.6 h), the difference was statistically significant (t=2.05, P=0.000); The time of hospitalization in TCT group (6.1±0.6 d) was less than that in PPH group (6.9± 0.5 d), the difference was statistically significant (t=1.78, P=0.002). TCT group of anastomotic secondary bleeding (0%) less than PPH group (8.9%), the difference was statistically significant (P=0.010). The stenosis of the TCT group (0%) was less than that of the PPH group (8.9%), the difference was statistically significant (P=0.010); The anal bulge of TCT group (1.7%) was less than that of PPH group (14.3%), the difference was statistically significant (P=0.014); The urinary retention in the TCT group (5%) was less than that in the PPH group (21.4%), the difference was statistically significant (P=0.011). ConclusionTCT group was superior to conventional PPH group in operation time, intraoperative blood loss, pain duration, hospitalization time, anastomotic secondary hemorrhage, anastomotic stenosis, anal bulge and urinary retention, Treatment of annular prolapse hemorrhoids, TCT can be used instead of PPH, worthy of clinical application.