吻合口位置高低与痔上黏膜环钉合术手术效果分析

目的探讨痔上黏膜环钉合术（PPH）的吻合门距齿线的距离对手术效果的影响。方法采用33mm痔上黏膜环形切除吻合器治疗脱垂性痔401例。其中Ⅱ度内痔45例,Ⅲ～Ⅳ度痔356例。吻合口在齿状线上1cm内219例、1～2cm87例、2～3cm60例、3-4cm25例、4cm以上10例。测量手术吻合口的部位,并将数据与手术治疗的效果进行分析。结果术中选择吻合口距齿线1～2cm者,术后发生脱垂率低（1．1％,1／87）,吻合口距齿线4cm以上,术后发生脱垂率较高（6／10）（X^2=102．2,P〈0．01）。结论吻合口的部位与手术效果有明屁的关系,吻合口在齿线2cm以内效果最好。

Analysis of the relationship between stoma position and postoperative effects of procedure for prolapse and hemorrhoids in the treatment of hemorrhoids

OBJECTIVE: To explore the relationship between stoma position and postoperative effects of procedure for prolapse and hemorrhoids (PPH) in the treatment of hemorrhoids. METHODS: Four hundred and one hemorrhoid patients were treated with circular stapler. II hemorrhoids, 45 cases; III-IV hemorrhoids, 356 cases. The position of stoma located 1 cm up dentate line, 219 cases; 1-2 cm up dentate line, 87 cases; 2-3 cm up dentate line, 60 cases; 3-4 cm up dentate line, 25 cases; > 4 cm up dentate line, 10 cases. The patients were followed from one week to two years postoperatively. RESULTS: Postoperative effects and procidentia rates have significant association with the position of stoma. If the distance between position of stoma and dentate line is < or = 2 cm, the postoperative procidentia rate was 1.1%, lower than that of the distance > or = 4 cm. CONCLUSIONS: The complication and procidentia rate of PPH is associated with the stoma position. The stoma position should be no more than 2 cm to dentate line.