PPH结合改良外剥内扎术治疗环状混合痔手术顺序探讨

为探讨PPH结合改良外剥内扎术治疗环状混合痔手术过程中的手术顺序问题，将510例环状混合痔患者分为两组，对照组254例先行改良外剥内扎术，再行PPH；观察组256例先行PPH，再行改良外剥内扎术。比较两组患者术中、术后并发症及近期疗效。结果显示，两组患者在术后创口疼痛、肛门排便功能、尿潴留、平均住院天数方面比较均无统计学意义（P〉0．05）；但观察组在术中血肿形成、术后肛缘皮赘、水肿、肛门渗液等方面均明显优于对照组（P〈0．05）。结果表明，先行PPH,再行改良外剥内扎术治疗环状混合痔，术中利于操作，术后患者近期并发症少，满意度高。

Discussion on the Surgical Sequence of PPH Combined with Improved External Dissection and Internal Ligation for Circumferential Mixed Hemorrhoids

This study was to discuss the surgical sequence of PPH combined with improved external dissection and internal ligation for circumferential mixed hemorrhoids, 510 cases were divided into control group（ n =254） and observation group（ n =256）. Control group received improved external dissection and internal ligation,then received PPH,while observation group underwent PPH followed by improved external dissection and internal ligation. Both groups were compared in intraoperative and postoperative complications and short-term clinical efficacy. The results showed that both groups showed no statistical significance in postoperative pain for wound,bowel movement function,urinary retention and average hospital stay（ P 〉0.05） ;however, observation group was superior to control group in intraoperative hematoma formation and postoperative skin tags,anal edema,anal exudates（ P 〈0.05）. It is concluded that PPH prior to improved external dissection and internal ligation for circumferential mixed hemorrhoids facilitates surgical manipulation,has fewer short-term complications and high satisfaction of patient.