痔上黏膜环切钉合术治疗混合痔合并非功能性排便梗阻综合征的临床观察及思考

目的观察痔上黏膜环切钉合术（PPH）治疗混合痔合并非功能性排便梗阻综合征（ODS）的临床疗效。方法回顾性分析50例采用PPH治疗的混合痔合并非功能性ODS患者的临床资料，随访12个月，观察治疗效果。结果基本痊愈11例，显效12例，有效12例，无效15例，总有效率70％（35／50），无效患者主要为合并直肠前突者。所有患者无一例发生死亡、吻合口感染、盆腔脓毒症等严重并发症。结论PPH操作简便，创伤小，对治疗混合痔合并直肠黏膜内套叠者安全有效，而对混合痔合并单纯直肠前突者疗效较差。

Clinical observation and thinking of procedure for prolaps and hemorrhoids in treatment of mixed hemorrhoids combined with non-functional obstructed defecation syndromes

Objective To observe the clinical effect of procedure for prolaps and hemofrhoids （PPH） in treatment of mixed hemorrhoids combined with non-functional obstructed defecation syndromes （ODS）. Methods The clinical data of 50 patients with mixed hemorrhoids combined with non-functional ODS treated by PPH were retrospectively analysed. All these patients were followed up for 12 months,the treatment outcome was observed. Results Eleven cases were basic cured, apparently effective in 12 cases, and effective in 12 cases, invalid in 15 cases ,the total effective rate was 70% （35/50）,inefficacy patients were mainly combined with rectocele. None patients had serious complications such as death,anastomotic infection and pelvic sepsis. Conclusion PPH convenient operation, small trauma,for the treatment of mixed hemorrhoids combined with internal rectal prolapse is safe and effective, but the effective is poorer in treatment of mixed hemorrhoids combined with rectocele.