吻合器在肛肠手术的应用观察

目的探讨在应用吻合器直肠下端黏膜环切吻合悬吊术（PPH）治疗直肠黏膜及组织松弛脱垂病理性变化为主的肛肠疾病手术中，扩大《PPH暂行规范》临床应用范围的可行性。方法对1307例环状脱垂内痔、混合痔、环状混合痔、嵌顿性混合痔，环状脱垂内痔、混合痔、环状混合痔伴有低位肛瘘或低位脓肿，直肠黏膜内脱垂、直肠全层脱垂，直肠前突症的患者采用PPH或PPH联合术式治疗，观察治疗效果。结果所有患者排便较术前明显顺畅，痔核的脱出、肛门的坠胀感及阻塞感消失，有效率100％。环状脱垂内痔、直肠黏膜内脱垂治愈率均为100％；混合痔、环状混合痔、嵌顿性混合痔治愈率95％；直肠全层脱垂痊愈率均为85％；直肠前突痊愈率62．7％。结论在临床中恰当的运用PPH治疗肛肠疾病，简化了手术过程、缩短了住院时间、降低了二次手术费用，为肛肠外科在治疗相关疾病提供新思路。

Clinical application and observation of procedure for prolapse and hemorrhoids in anorectal operation

Objective To explore the effect of procedures for prolapse and hemorrhoids (PPH) in treatment of colorectal disease based on rectal mucosa or tissue prolapse.Methods Totally 1307 cases of circumferential prolapsed internal hemorrhoids,mixed hemorrhoid,circumferential prolapsed mixed hemorrhoids,incarcerated mixed hemorrhoid,circumferential prolapsed internal hemorrhoids,mixed hemorrhoid,circumferential prolapsed mixed hemorrhoids with low anal fistula or abscess,internal rectal mucosal prolapse,complete rectal prolapse and rectocele were treated by PPH or PPH combined with operation.Results After the treatment,All patients defecated smoother than before.The symptoms of hemrrhoidal prolapse,heavy feeling in anus and obstruction disappeared.All the patients received PPH and the improvement rate was 100%.The cure rates of circumferential prolapsed internal hemorrhoids and internal rectal mucosal prolapse were all 100%.The cure rates of mixed hemorrhoid,circumferential prolapsed mixed hemorrhoids,incarcerated mixed hemorrhoid were all 95%.The cure rates of complete rectal prolapse and rectocele were 85% and 62.7%.Conclusion PPH can simplify surgical procedures and shorten the length of stay in hospital and reduce the cost of secondary surgery.