吻合器痔上黏膜环切术治疗混合痔临床观察

目的:探讨吻合器痔上黏膜环切术(procedure for prolapse and hemorrhoids, PPH)治疗混合痔的临床疗效。方法:采用 PPH治疗以Ⅲ～Ⅳ期内痔为主的混合痔36例,术前做好心理护理及手术准备,密切观察患者术后一般情况及并发症发生情况,给予正确的饮食指导和康复指导。结果:平均手术时间为18min,术后1d 疼痛17例(47.2%),尿潴留11例(30.6%),水肿5例(13.9%),大便带血3例(8.3%),住院时间3～4d,术后无大便失禁、肛门狭窄及肛周脓肿,随访6个月无复发。结论:采用 PPH 治疗Ⅲ～Ⅳ期混合痔手术时间短,术后疼痛轻、恢复快,是治疗混合痔的理想方法。

Clinical Observation of the Procedure for Prolapse and Hemorrhoids in the Treatment of Mixed Hemorrhoids

Objective： To evaluate the clinical efficacy of stapled hemorrhoidopexy （ procedure for prolapse and hemorrhoids, PPH） in the treatment of mixed hemorrhoids. Methods： The PPH treated 36 cases of stage Ⅲ～Ⅳ mixed hemorrhoids,had good psychological care and surgical preparation before surgery, close observed the general of postoperative complications, given the correct dietary guidance and rehabilitation guidance. Results： The mean operative time was 18 minutes. Postoperative pain incidence of 17 cases （47.2% ）, urinary retention of 11 cases （30.6% ）, edema of 5 cases （13.9% ）, blood in the stool of 3 cases （8.3% ）,stayed in the hospital 3～4 days, no postoperative fecal incontinence, anal stenosis and perianal abscess, recurrence-free 6-month follow-up. Conclusion： The PPH treatment of stage Ⅲ～Ⅳ mixed hemorrhoid operating time is shorter, the postoperative pain is more lightly, the recovery is shorter, is a good treatment of the mixed hemorrhoid.