外切内注缝合术治疗环状混合痔疗效观察

为提高环状混合痔临床疗效，减少术后并发症和后遗症发生，应用外切内注缝合术治疗环状混合痔30例（试验组），用外剥内扎术（Milligan-Morgan手术）治疗30例（对照组）。观察两组术后疼痛、出血、切口皮瓣水肿、切口愈合、肛门管径大小、皮赘残留等变化。结果显示，试验组治愈28例，1例切口皮瓣严重水肿再次行局部修整后延迟愈合，1例出现肛门狭窄行肛门松解术后治愈，无大出血病例，平均治疗时间（6．2±1．1）d；对照组治愈24例，2例大出血，11例皮瓣水肿经局部热敷和坐浴后3例严重者行再次手术后治愈，2例肛管狭窄行肛门松解扩肛后治愈，平均治疗时间（7．0±0．3）d。结果表明，外切内注缝合术治疗环状混合痔具有治愈率高，并发症与后遗症少，治疗时间短等优点。

Observation on the Therapeutic Efficacy of the Combined Procedure of External Resection,Internal Sclerotherapy and Suture in the Treatment of Circumferential Mixed Hemorrhoids

The objective of this study was to evaluate the therapeutic efficacy of the combined procedure of external resection, internal sclerotherapy and suture（ERISS） in the treatment of circumferential mixed hemorrhoids（CMH）. 30 patients underwent ERISS（the study group）,while another 30 patients underwent Milligan-Morgan procedure（MM）（the controlled group）. The indexes of postoperative pain, bleeding, edema of incision flap, wound healing, anus diameter and residual skin tags were recorded and compared. As results,cure was achieved in 28 cases, serious incision flap edema occurred in one case（cured after local repair） ,and anal stricture occurred in one case（cured after anus-releasing procedure）,had no massive bleeding and the average hospital stay was （6.2±1.1）days in the study group;while in the controlled group, cure was achieved in 24 cases, massive hemorrhage occurred in 2 cases, edema occurred in 11 cases, they were all cured after local fomentation and hip bath except that 3 cases underwent surgical treatment, anal stricture occurred in 2 cases（cured after anus-releasing procedure）,and the average hospital stay was （7.0±0.3）days. It is concluded that ERISS has such advantages as higher in cure rate,less in complications and sequelea,and shorter in treatment course.