PPH结合外剥内扎术治疗混合痔的临床观察

为观察PPH结合外剥内扎术治疗混合痔的疗效，将90例混合痔患者随机分为对照组、PPH组和结合组，每组30例。对照组采用外剥内扎术治疗，PPH组采用PPH治疗，结合组采用PPH结合外剥内扎术治疗，观察3组患者手小后的一般情况，比较术后并发症。结果显示，3组患者均治愈，在术后出血、肛门狭窄、术后肛缘水肿方面差异无统计学意义（P〉0．05）；PPH组在手术时间、术后24h疼痛评分方面与其余两组差异具有统计学意义（P〈0．05）；PPH组与结合组红术后3d、7d疼痛评分、恢复工作时间方面差异无统计学意义（P〉0．05），而与对照组比较具有统计学意义（P〈0．05）；结合组与对照组、PPH组在患者满意度方面差异具有统计学意义（P〈0．05）。结果表明，PPH结合外剥内扎术的创伤小于外剥内扎术，术后疼痛明显优于外剥内扎术。该法可降低PPH术后的复发率和并发症的发生率，减轻患者术后不适，提高患者的满意度。

Clinical Observation on PPH Combined with External Dissection and Internal Ligation for Mixed Hemorrhoids

This study was to observe the clinical efficacy of PPH combined with external dissection and in ternal ligation for mixed hemorrhoids,90 cases of mixed hemorrhoids were randomized into control group, PPH group and combination group,30 cases for each group. Control group underwent external dissection and internal ligation, PPH group received PPH, and combination group were treated by PPH combined with external dissection and internal ligation. All the three groups were observed for their general condition after surgery and compared for postoperative complications. The results showed that all the patients in the three groups got cured,which showed no significant difference in bleeding case,anal stenosis and anal edge edema（ P〉0.05） ;PPH group was significantly different from the other two groups in operation time and pain scores 24h after operation（ P 〈0.05） ;no significant difference was found between any pairs of PPH group and combination group in pain scores 3d and 7d after operation, and time for returning to work （ P〉 0.05） ,but they were significantly different from the controls（ P 〈0.05） ;significant difference was found between PPH group,control group and combination group in patient＇s satisfaction（ P 〈0.05）. It is concluded that PPH combined with external dissection and internal ligation is less invasive and superior to simple external dissection and internal ligation in postoperative pain. This surgical procedure can also lower the recurrence rate and incidence of complications of PPH, reduce postoperative discomfort of patient and improve patient＇s satisfaction.