两种荷包缝合技术在PPH治疗重度痔病疗效对照研究

目的 比较两种不同的缝合方法对痔上粘膜环切术（PPH)治疗重度痔病的疗效。方法 对162 例Ⅲ、Ⅳ度痔病行PPH术，随机采用单荷包缝合组（A组，n=92）与双荷包缝合组（B组，n=70），分析比较两组病例的手术时间、环切直肠粘膜内出血情况、环切直肠粘膜宽度、环切粘膜完整性、术中出血量、术后肛门疼痛、住院时间。结果 单荷包缝合法（A组）手术时间较双荷包缝合法（B组）缩短，环切直肠粘膜内出血情况、术中出血量、术后肛门疼痛例数等A组均少于B组，以上对比数据均有显著差异(P<0.O5)。环切直肠粘膜宽度、环切粘膜完整性、住院时间等无显著性差异(P<0.O5)。结论 单荷包缝合在PPH术中的应用具有手术时间短，减少粘膜内出血，能有效切除一定厚度的粘膜，是治疗重度痔病的好方法。

Comparative study on two kinds of purse-string suture in the use of PPH for treating severe hemorrhoids

Objective To compare the clinical effects on two different purse-string suture methods in the procedure for prolapsed and hemorrhoids （PPH） for the treatment of severe hemorrhoids. Methods One hundred and sixty two cases with Ⅲ° and IV° prolapsed hemorrhoids received PPH were randomly divided into single purse-string suture group （Group A, n=92） and double purse-string suture group （Group B,n=70）. The operative time, circular resected rectal mueosal width, intect circular resected mucosa, volume of intraoperative blood lose, postoperative anal pain and hospitalization time were compared between two groups. Results In the operative time ,the group A was shorter than that group B.In the circular reseeted rectal intramueosal bleeding,volume of intraoperative blood lose and case of postoperative anal pain, the group A was less than that group B and there were significant difference （P〈0.05）.In the circular resected rectal mucosal width, intect circular resected mucosa and hospitalization time,there were no significant difference between two groups （P〉0.05）. Conclusion Single purse-string suture in the use of PPH possesses a short operative time, less blood lose and effective resected definite thickness mucosa. It is a good method for the treatment of Ⅲ° and IV° hemorrhoids.