PPH加外痔切除术治疗重度痔

为探讨PPH加外痔切除术治疗重度痔的可行性及术中、术后并发症的发生和防治对策，对92例采用PPH加外痔切除术治疗的Ⅲ、Ⅳ期内痔伴结缔组织性外痔患者的临床资料进行回顾性分析。结果显示，所有病例术后肛门平整、光滑，痔核回缩率100％，无肛周感染、肛门狭窄及肛门失禁；术中下腹部-过性疼痛8例，占8．7％；吻合口搏动性出血16例，占17．0％；术后大便带血19例，占20．0％；尿潴留29例，占31．5％；肛门Ⅲ度疼痛8例，占8．7％；肛门感觉障碍9例，占9．8％。结果表明，PPH加外痔切除术治疗重度痔局部疼痛轻，效果满意；无术后大出血、肛周感染病例发生，无肛门狭窄、肛门失禁等并发症和后遗症。

The Combined Procedure of PPH plus Resection of External Hemorrhoids in the Treatment of Severe Hemor- rhoids

The combined procedure of PPH plus resection of external hemorrhoids（PPH-REH） had been applied to the treatment of severe hemorrhoids（internal hemorrhoids Ⅲ and Ⅳ stages with connective tissue external hemorrhoids）, so as to explore the feasibility,incidence of intro-postoperative complication and its prevention ＆ treatment measures;the 92 patients had undergone the procedure. Their clinical data were analyzed retrospectively. As results, neat and smooth anus in all patients after operation, hemorrhoid retraction rate was 100%,and there were no perianal infection,anal stricture or anal incontinence postoperatively; while there was transient lower abdominal pain during operation in 8 cases （8.7%）, action bleeding in the anastomotic stoma in 16 cases（17.0%）,hematochezia in 19 cases（20.0%）, urine retention in 29 cases （31.5%）,anal pain（Ill degree） in 8 cases（8.7%） and dysesthesia in 9 cases（9.80/00）. It is concluded that PPH-REH can ensure a definite efficacy in terms of better therapeutic outcome, no postoperative complications and sequelae such as massive bleeding,Derianal infection ,anal stricture and anal incontinence etc.