吻合器痔上粘膜钉合术治疗重度痔技术改进

目的探讨吻合器痔上粘膜钉合术(procedure for prolapse haemorrhoids, PPH)的技术改进,以减少并发症,提高疗效. 方法将87例行PPH术患者随机分为技术改进组(A组)46例和常规手术对照组(B组)41例.A组的技术改进主要包括双荷包缝合、缝合至粘膜下层、肛管外减压、消痔灵内痔注射等.观察手术时间、术后疼痛、住院时间、术后并发症及术后复发率. 结果比较手术时间、术后疼痛、住院时间,两组无显著性差异(P>0.05);但A组肛门功能恢复时间短,术后并发症发生率低,复发率低,两组比较有显著性差异(P<0.05). 结论通过对PPH进行技术改进,可以扩大其临床适应证,减少术后并发症,降低术后复发率,提高疗效.

A Technique Modification of PPH for Severe Hemorrhoid

Objective To evaluate the effect of a techni qu e modification of procedure for prolapsed hemorrhoids (PPH) for severe hemorrhoi d. Method 87 patients were randomly divided into two gro ups: group A underwent modified PPH and group B underwent unmodified PPH. The im provements mainly included double purse-string suture, suture into unica submuc osa, extra-anal decompression through anal tube and haemorrhoid injection. Oper ation time, hospital stay, post-operative pain, complication and recurrence wer e observed and compared. Result Comparing with group B, the complication rate and recurrent rate were significantly lower in group A ( P<0.05), while the operation time, post-operative pain and hospital stay show ed no significant difference between two groups (P>0.05). Conclu sions The modification of PPH can expand its clinical indications, r educe the complications and recurrent rates, and improve its effect.