痔上黏膜环切钉合术与Ligasure血管闭合术治疗痔的疗效比较

目的探讨痔上黏膜环切钉合术（PPH）与用Ligasure血管闭合技术（LT）治疗痔的临床疗效。方法将86例Ⅲ度痔患者在知情同意后，随机分为PPH组（44例）和LT组（42例）。比较两组患者的手术时间、住院时间和术后疗效及出血、疼痛及费用。结果（1）手术时间：LT组为（12．0±4．1）min；PPH组为（19．0±6．4）min，差异有统计学意义（P〈0．05）。（2）疼痛：术后24h视觉模拟疼痛（VAS）评分PPH组和LT组分别为3．1（2．6）和5．4（3．8），差异有统计学意义（P〈0.05）。（3）费用：LT组为（4838±301）元，PPH组为（7796±492）元，差异有统计学意义（P〈0．05）。（4）并发症：PPH组术后出血（超过50ml）4例，复发1例；LT组无术后出血（1次量〉50ml）和复发。（5）满意度调查：术后6个月时，患者对手术疼痛、排便和总体满意度进行自我评分，PPH组分别为95．0％、100％和100％，LT组则分别为87．2％、97．4％和97．4％；两组差异无统计学意义（P〉0．05）。结论LT和PPH都是治疗痔的有效方法。LT与PPH比较，具有术中及术后几乎不出血、手术时间更短和费用更低的优点。但术后疼痛较为明显。

Therapeutic comparison between procedure for prolapse and hemorrhoids and Ligasure technique for hemorrhoids

OBJECTIVE: To investigate and compare the clinical effects of procedure for prolapse and hemorrhoids (PPH) and Ligasure technique (LT) for the treatment of severe hemorrhoids. METHODS: Patients with prolapsed hemorrhoids were randomly divided into two groups treated with PPH (n=44) and LT (n=42). The outcomes were evaluated postoperatively (i.e., operation time, length of hospital stay, pain intensity scoring, relapse of prolapse, bleeding and cost). RESULTS: (1)The average operating time for patients treated by LT was (12.0+/- 4.1) min, while for those by PPH was(19.0+/- 6.4)min (P < 0.05). (2)The average scores of visual analogue scale (VAS) for PPH and LT patients were 3.1 points (2 approximately 6) and 5.4 points (3~8) respectively(P < 0.05). (3)The average costs for LT group and PPH group were (4838+/- 301) yuan and (7796+/- 492) yuan respectively (P < 0.05). (4)In PPH group, 4 patients were complicated with hemorrhage (over 50 ml) and 1 patients with relapse, while there were no complications occurred in LT group. (5)Six months after operation, the self scores of postoperative pain,defecation and total satisfaction were 95.0%, 100% and 100% in PPH group, and 87.2%, 97.4% and 97.4% in LT group respectively. CONCLUSIONS: Compared with PPH, LT has the advantages of shorter operation time, less hemorrhage and expense, but more postoperative pain. Both LT and PPH are effective procedures for severe hemorrhoids.