吻合器痔上黏膜环切术治疗环状混合痔的临床疗效

目的：探讨吻合器痔上黏膜环切术治疗环状混合痔的临床疗效。方法将新疆医科大学第一附属医院肛肠科收治的86例环状混合痔患者，按术式不同分为吻合器痔上黏膜环切术组（PPH 组）和传统外剥内扎术组（对照组），每组43例，比较两组患者的手术时间、术中牵拉及不适感、术后住院时间、术后疼痛、术后出血、术后肛周水肿、术后皮赘发生等指标。结果与对照组相比，PPH 组手术时间短，术中牵拉及不适感明显，术后住院时间短，术后疼痛轻，术后肛周水肿轻，两组差异有统计学意义（P 均＜0．05）；两组术后出血、术后皮赘发生差异均无统计学意义（P 均＞0．05）。结论吻合器痔上黏膜环切术可作为环状混合痔的替代手术，但要考虑到术中存在牵拉及不适感的问题。

Clinical efficacy observation of procedure for prolapse and hemorrhoids to treat circumferential mixed hemorrhoid

Objective To investigate the clinical efficacy of procedure for prolapse and hemorrhoids （PPH） to treat circumferential mixed hemorrhoid.Methods 86 patients were Collected with circumferential mixed hemorrhoid .According to the surgical method,43 patients received the PPH （PPH group）while the other 43 patients received the traditional Milligan surgery （control group）.Patients in each group would be followed up with at least 6 months after the surgery,and analyzed with the index with operation time,intraoperative force and discomfort,post-operation hospitalization duration,post-operation pain, post-operation bleeding,post-operation edema,post-operation skin tag occurance.Results Compared with the traditional Milligan surgery,patients received the PPH have the characteristic of shorter operation time,more intraoperative force and discomfort feeling,shorter post-operation hospitalization duration,less post-operation pain （P 〈0.05）.The index difference of bleeding,skin tag occurance after the surgery all have no statistical significance （P 〉0.05）.Conclusion PPH in the treatment of circumferential mixed hemorrhoid might be an alternative surgical method,the problem of more intraoperative force and discomfort feeling also should be concerned.