自动痔疮套扎术联合外剥内扎术治疗混合痔的临床效果

目的　探讨自动痔疮套扎术（Ruiyun procedure for hemorrhoids，RPH）联合外剥内扎术（Milligan-Morgan，M-M术）治疗混合痔的临床效果。方法　选择2016年1月1日至2020年3月1日期间罗定市人民医院普外科收治的Ⅲ～Ⅳ度混合痔患者145例，按照随机数字表法分为对照组和观察组。对照组70例，男30例，女40例，年龄（44.97±9.86）岁，给予传统的M-M术治疗；观察组75例，男32例，女43例，年龄（45.83±10.27）岁，采用RPH联合M-M术治疗，并比较两组治疗效果、围术期指标及不良反应发生率、痔疮复发率。采用独立样本t检验和χ²检验。结果　观察组手术时间及创面愈合时间均短于对照组（t=7.135、5.986，均P<0.05），术中出血量明显少于对照组（t=6.372，P<0.05）；观察组总有效率为100.00%（75/75），对照组为100.00%（70/70），差异无统计学意义（P>0.05）；观察组术后随访3个月并发症发生率2.67%（2/75），6个月复发率1.33%（1/75），明显低于对照组的10.00%（7/70）、7.14%（5/70）（χ²=3.345、3.081，均P<0.05）。结论　RPH联合M-M术治疗混合痔疗效肯定，有效缩短了手术时间及创面愈合时间，减少了术中出血量，显著降低了并发症发生率及复发率。

Ruiyun procedure for hemorrhoids combined with Milligan-Morgan in treatment of mixed hemorrhoids

Objective　To investigate the clinical effect of Ruiyun procedure for hemorrhoids (RPH) combined with Milligan-Morgan (M-M procedure) in the treatment of mixed hemorrhoids. Methods From January 1, 2016 to March 1, 2020, 145 patients with mixed hemorrhoids of grade Ⅲ to Ⅳ who were admitted to Department of General Surgery, Luoding People's Hospital were selected and divided into a control group and an observation group by the random number table method. The control group had 70 cases, including 30 males and 40 females who were (44.97±9.86) years old, and were treated with M-M procedure. The observation group had 75 cases, including 32 males and 43 females who were (45.83±10.27) years old, and were treated with RPH and M-M procedure. The therapeutic effects, perioperative indicators, incidences of adverse reactions, and recurrence rates of hemorrhoids were compared between these two groups. The independent-sample t and χ² tests were applied. Results　The operation time and wound healing time of the observation group were shorter than those of the control group (t=7.135 and 5.986, both P<0.05); the intraoperative bleeding volume of the observation group was significantly less than that of the control group (t=6.372, P<0.05). The total effective rate was 100.00% (75/75) in the observation group, and was 100.00% (70/70) in the control group, with no statitical difference (P>0.05). The incidence of complications during 3 months' follow up after the operation and the 6-month recurrence rate were 2.67% (2/75) and 1.33% (1/75) in the observation group, and were 10.00% (7/70) and 7.14% (5/70) in the control group, with statistical differences (χ²=3.345 and 3.081, both P<0.05). Conclusion　RPH combined with M-M procedure in the treatment of mixed hemorrhoids is effective and can effectively shorten the operation time and wound healing time, and reduce intraoperative bleeding volume, complications, and recurrence.