| 摘要: |
| 目的 研究上提固定结合整形微创治疗Ⅲ、Ⅳ度混合痔的临床疗效。方法:选取2021年1月—2022年3月收治的80例混合痔患者，按就诊单双日次序分为治疗组和对照组，每组各40例。治疗组采用上提固定结合整形微创治疗混合痔，对照组采用混合痔外切内扎术。比较两组临床疗效、术后第1、3、7天疼痛评分、肛周水肿评分以及便血评分，首次排便时间、排便疼痛消失时间、便血消失时间、住院时间、恢复工作时间，术后肛门功能评价及复发情况。结果:两组的总有效率差异无统计学意义(P＞0.05)。治疗组术后1、3、7 d的VAS疼痛评分、肛周水肿评分及便血评分均低于对照组，差异有统计学意义(P<0.05)。治疗组患者的首次排便时间、排便疼痛消失时间、便血消失时间、住院时间、恢复工作时间均低于对照组，差异有统计学意义(P<0.05)。治疗组患者在术后1周、术后1个月的肛门失禁Wexner评分均明显低于对照组(P<0.05)，而在术后4、8个月时，两组患者评分无明显差异(P＞0.05)。在术后8个月电话随访中，两组患者未诉复发情况。结论:上提固定结合整形微创治疗Ⅲ、Ⅳ度混合痔疗效确切，在减轻术后肛门疼痛、肛周水肿、便血等症状及降低手术对肛门功能影响方面优势明显。 |
| 关键词: 混合痔 内痔注射 自动定量弹力线痔套扎术 整形微创 |
| DOI：10.3969/j.issn.1007-6948.2024.02.003 |
|
| 基金项目:盐城市医学科技发展计划项目(YK2020114) |
|
| Clinical research of lifting fixation combined with minimally invasive plastic surgery for the treatment of III or IV mixed hemorrhoids |
| CHEN Peng,HANG Chun-ping |
| Department of Proctology, Yancheng Dafeng Hospital of Traditional Chinese Medicine, Jiangsu Yancheng 224100,China |
| Abstract: |
| Objective To study the clinical efficacy of lifting fixation combined with minimally invasive plastic surgery for the treatment of III or IV mixed hemorrhoids. Methods 80 patients with mixed hemorrhoids in the undergraduate ward from January 2021 to March 2022 were included as research subjects. They were divided into treatment group and control group according to the order of single and double day visits, with 40 cases in each group. Patients in the treatment group received lifting fixation combined with minimally invasive plastic surgery, and milligan-morgan hemorrhoidectomy was performed in the control group. The clinical efficacy, pain scores, perianal edema score, and hematochezia scores on days 1, 3 and 7 after surgery were compared between the two groups. The time of first bowel movement, time to disappearance of defecation pain, disappearance of blood in stool, length of hospital stay, and recovery time of the two groups; Postoperative function evaluation and recurrence. Results The overall efficacy of the treatment group was 95% higher than that of the control group by 90%, but the difference was not statistically significant (P>0.05). The VAS pain score, perianal edema score and hematochezia score in the treatment group were lower than those in the control group at 1, 3 and 7 days after surgery, and the differences were statistically significant (P<0.05). The first bowel movement time, defecation pain disappearance time, blood in the stool disappearance time, length of hospital stay, and recovery time of the treatment group were all lower than those in the control group, and the differences were statistically significant (P<0.05). The Wexner scores of incontinence in the treatment group were significantly lower than those in the control group (P<0.05) at 1 week and 1 month after surgery, while there was no significant difference in the scores between the two groups at 4 months postoperative and 8 months after surgery (P>0.05). At 8 months postoperative telephone follow-up, no recurrence was reported in either group. Conclusion Lifting fixation combined with minimally invasive plastic surgery has a definite effect on the treatment of mixed hemorrhoids, and has obvious advantages in reducing postoperative pain, perianal edema, blood in the stool and lowering the impact of surgery on function. |
| Key words: Mixed hemorrhoids internal hemorrhoidal injections automatic quantitative elastic line hemorrhoidal ligation minimally invasive plastic surgery |
