采用痔上黏膜环切吻合器治疗重度痔临床研究

目的 观察应用痔上黏膜环切术（PPH）治疗痔的临床效果.方法 Ⅱ、Ⅲ、Ⅳ度痔患者78例,均接受PPH治疗,记录诊断、病史、手术时间、出血量及围手术期并发症.手术前和手术后6h、24h、1个月采用世界卫生组织生活质量量表（WHOQOL-BREF）对患者进行评分.结果 术后疼痛视觉模拟评分（VAS）在6h评分为（7.6±2.1）分,术后24 h VAS评分减少至（1.3±1.1）分.术后并发症发生率较传统手术低（t=1.994,P=0.032）;术后生活质量总体评分、健康总体评分、身体状况和心理状况评分均显著改善（t=1.901、1.805、1.714,P=0.041、0.038、0.029,均P＜0.05）,环境评分有轻度改善,但差异无统计学意义（P＞0.05）,社会生活评分没有变化.结论 PPH手术取得良好的临床效果,并发症发生率低,患者生活质量得到提高,对于痔患者应作为推荐的首选手术方式.

Clinical study on procedure for prolapse and hemorrhoids （PPH） in treating hemorrhoids

Objective To observe the clinical effect of procedure for prolapse and hemorrhoids （PPH） in treating hemorrhoids.Methods 78 patients with symptomatic Ⅱ,Ⅲ and Ⅳ degree hemorrhoids undergoing PPH were selected in this study.The diagnosis,medical history,operative time,blood loss and perioperative complications were recorded.The World Health Organization Quality of Life Scale（WHOQOL-BREF） was observed preoperation and 6 hours,24 hours,1 month postoperation.Results The postoperative pain score measured by visual analogue scale （VAS） at postoperative six hours was （7.6 ± 2.1）,which reduced to （1.3 ± 1.1） at 24 hours.There was significant improvement in the overall perception of QOL,health,and in physical and psychological domains （t =1.901,1.805,1.714,P =0.041,0.038,0.029,all P ＜ 0.05）.There was modest improvement in environmental domain,while no change was found in social domain （P ＞ 0.05）.Conclusion PPH surgery achieves good clinical results,improved quality of life of patients,with a low incidence of complications,patients with hemorrhoids should be recommended for this preferred surgical approach.