痔上黏膜切除术辅助外痔切剥术在重度混合痔中的临床疗效

目的探讨痔上黏膜切除术（PPH）辅助外痔切剥术在重度混合痔中的临床疗效。方法采用前瞻性对照研究,将2010年1月至2012年12月潮安县人民医院普通外科收治的120例混合痔患者随机分成三组：PPH辅助外痔切剥术组（PE组,40例）、单纯PPH术组（P组,40例）、外痔内扎术组（E组,40例）。比较三组患者的临床疗效、手术时间、住院时间、切口愈合时间、术后并发症和术后3个月复发率。结果 PE组手术疗效比P组和E组显著增高（P〈0.05）;PE组和P组患者术后出血、水肿、肛门狭窄、术后VAS疼痛评分和术后3个月复发率比E组均明显减少,差异有统计学意义（P均〈0.05）;PE组患者术后VAS疼痛评分和术后3个月复发率较P组均明显减少,差异有统计学意义（P均〈0.05）。结论 PPH辅助外痔切剥术治疗重度混合痔疗效确切,术后并发症少,术后复发率低,值得临床大力推广。

Clinical efficacy of procedure for prolapse and hemorrhoids assisted external hemorrhoids dissection on patients with severe mixed hemorrhoids

Objective To investigate the clinical efficacy of procedure for prolapse and hemorrhoids（PPH） assisted external hemorrhoids dissection on patients with mixed hemorrhoids.Methods From Jan.2010 to Dec.2012,60 patients with mixed hemorrhoids were divided into three groups（each contained 40 patients） ： group PE（PPH assisted external hemorrhoids dissection）,group P（PPH） and group E（external hemorrhoids dissection and internal ligation procedure）.The clinical efficacy,operation duration,hospitalization time,recovery time,postoperative vomplications,wound healing time and relapse rate at 3 months after operation were recorded.Results The clinical efficacy of group PE was higher than that in group P and group E,there were significant differences（P 0.05）.Compared with group E,the postoperative hemorrhage,edema,anal stenosis,VAS score and relapse rate at 3 months after surgery were all decreased in group PE and group P,there were significant differences（P 0.05）.Compared with group P,the postoperative VAS score and relapse rate at 3 months after surgery were both decreased in group PE,there were significant differences（P 0.05）.Conclusion PPH assisted external hemorrhoids dissection has remarkable clinical efficacy,with fewer postoperative complications and lower relapse rate,so it is worthy of clinical popularization.