| 摘要: |
| 目的:探究保留肛垫整形术联合PPH治疗Ⅲ、Ⅳ度混合痔的疗效及对肛门功能的影响。方法:采用随机数字表法将92例重度混合痔患者随机分为对照组和观察组，每组46例，对照组采用Milligan-Morgan术治疗，观察组采用保留肛垫整形术联合PPH治疗。比较两组患者的一般资料；比较两组患者术后情况；比较两组患者的临床疗效；比较两组患者术前、术后的肛门功能评分并采用随机行走模型进行评价；比较两组患者术后并发症发生情况；采用Kaplan-Meier法绘制生存曲线，比较两组患者在1年随访期间的未复发率。结果:对照组和观察组患者的手术时间分别为(47.06±3.87)min和(38.64±5.12)min，术中出血量分别为(45.18±7.42)mL和(25.31±4.05)mL，住院时间分别为(8.12±1.53)d和(5.62±1.37)d，术后24 h疼痛VAS评分分别为(5.34±1.32)分和(4.48±1.40)分，第一次排便疼痛持续时间分别为(34.15±5.43)min和(24.25±4.28)min，水肿时间分别为(4.96±1.18)d和(3.51±0.78)d，带血时间分别为(5.53±0.82)d和(4.02±0.74)d，治疗总有效率分别为67%和96%，术后未复发率分别为37%和87%，术后14 d的肛门功能Wexner总评分明显增加，分别为(10.42±1.85)分和(8.42±1.78)分，差异均具有统计学意义(P<0.05)。结论:保留肛垫整形术联合PPH治疗Ⅲ、Ⅳ度混合痔能明显降低患者术后疼痛、水肿及出血量，提高患者的治疗效果，降低复发率，维持了肛门功能，保证肛门精细控便能力不受影响。 |
| 关键词: 保留肛垫整形术 吻合器痔上黏膜环切术 混合痔 肛门功能 |
| DOI：10.3969/j.issn.1007-6948.2021.05.017 |
| 投稿时间：2020-12-30 |
| 基金项目: |
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| Cushion-Preserving Plastic Surgery Combined with PPH in the Treatment of Grade Ⅲ and Grade Ⅳ Mixed Hemorrhoids and Its Effect on Anal Function |
| WU Wei,NINGYu-yong,ZHANG Yu |
| Department of Anorectal Surgery, General Hospital of Wanbei Coal Power Group, Suzhou 234000, China |
| Abstract: |
| Objective To explore the effect of anal cushion-preserving plastic surgery combined with PPH in the treatment of grade III and IV mixed hemorrhoids and its influence on anal function. Methods 92 patients with severe mixed hemorrhoids were randomly divided into control group (n=46) and observation group (n=46). The control group was treated with Milligan-Morgan operation and the observation group was treated with anal pad-preserving plastic surgery combined with PPH.The general data of the two groups were compared; the postoperative conditions of the two groups were compared; the clinical effects of the two groups were compared; the preoperative and postoperative anal function scores of the two groups were compared and evaluated by random walking model; the postoperative complications of the two groups were compared; the survival curve was drawn by Kaplan-Meier method, and the non-recurrence rate of the two groups during the 1-year follow-up period was compared. Results The operation time of the control group and the observation group was (47.06±3.87) min and (38.64±5.12) min, the intraoperative blood loss was (45.18±7.42) mL and (25.31±4.05) mL respectively, and the hospital stay was (8.12±1.53) days and (5.62±1.37) days.The pain VAS scores were (5.34±1.32) points and (4.48±1.40) points at 24h postoperatively, and the durations of first defecation pain were (34.15±5.43) min and (24.25±4.28) minrespectively.The edema time was (4.96±1.18) d and (3.51±0.78) d, and the blood-bearing time was (5.53±0.82) d and (4.02±0.74) d, respectively. The total effective rates of treatment were 67% and 96% respectively. The postoperative non-recurrence rates were 37% and 87% respectively. The Wexner total score of anal function at the 14th day after surgery increased significantly, which were (10.42±1.85) points and (8.42±1.78) points respectively. The differences were statistically signi?cant (P<0.05). Conclusion Anal cushion-preserving plastic surgery combined with PPH for the treatment of mixed hemorrhoids of grade III |
| Key words: anal cushion preserving plastic surgery procedureforprolapse andhemorrhoids mixed hemorrhoids anal function |
