摘要
目的观察改良切开减压术结合外剥内扎术治疗环状混合痔的临床疗效。方法将2017年11月至2018年12月广安市人民医院收治的200例环状混合痔患者随机分为对照组与观察组,每组各100例,对照组给予混合痔外剥内扎术治疗,观察组给予改良切开减压术结合外剥内扎术治疗。观察两组术后排便后肛门疼痛、切口水肿、切口出血、术后住院时间、创面愈合时间、肛门狭窄、肛门失禁、治愈率等指标。结果两组术后第1天排便后肛门疼痛评分比较差异无统计学意义(P>0.05),术后第3天、5天、7天排便后肛门疼痛评分比较,观察组低于对照组,差异均有统计学意义(均P<0.05);两组术后第1天切口水肿严重程度比较差异无统计学意义(P>0.05),术后第3天、7天、14天切口水肿比较,观察组水肿严重程度轻于对照组,差异均有统计学意义(均P<0.05);两组术后第1天、3天、5天肛门出血严重程度比较差异均无统计学意义(均P>0.05),术后第7天肛门出血比较,观察组肛门出血严重程度轻于对照组,差异有统计学意义(P<0.05);观察组切口愈合时间短于对照组,差异有统计学意义(P<0.05);观察组肛门狭窄严重程度轻于对照组,差异有统计学意义(P<0.05);两组肛门失禁情况比较差异无统计学意义(P>0.05);两组术后随访,两组均未出现未愈病例,观察组治愈率(94%)高于对照组(85%),差异有统计学意义(P<0.05);观察组治疗效果优于对照组,差异有统计学意义(P<0.05)。结论改良切开减压术结合外剥内扎术治疗环状混合痔,疗效确切,能减轻术后并发症严重程度,同时有效预防术后肛门狭窄、肛门失禁和促进创面愈合。
Objectives To investigate the effect of modified open decompression combined with Milligan-Morgan hemorrhoidecto my for circumferential mixed hemorrhoid. Methods Two hundred patients with circumferential mixed hemorrhoids treated in West China-Guang’an Hospital, Sichuan University between November 2017 and December 2018 were randomly assigned to the treatment group and control group with 100 patients in each group. Patients in the control group were treated with Milligan-Mor gan hemorrhoidectomy and those in the treatment group by modified open decompression combined with Milligan-Morgan hemor rhoidectomy. The followings were recorded: postoperative anal pain during defecation, incisional edema, incisional bleeding, hospi talization time, time to wound healing, anal stenosis, incontinence, and rate of cure. Results There was no difference in anal pain score between the two groups on day 1 after surgery ( P > 0.05). Pain scores were significantly lower in the treatment group than in the control group on day 3, 5, and 7 after surgery ( P < 0.05). There was no difference in incisional edema between the two groups on day 1 after surgery ( P > 0.05). Incisional edema was significantly less severe in the treatment group than in the control group on day 3, 7, and 14 after surgery ( P < 0.05). There was no difference in anal bleeding between the two groups on day 1, 3, and 5 after surgery ( P > 0.05). Anal bleeding was significantly less severe in the treatment group than in the con trol group on day 7 after surgery ( P < 0.05). Time to wound healing was significantly shorter and anal stenosis was significantly less severe in the treatment group than in the control group ( P < 0.05). No significant difference was observed between the two groups in incontinence ( P > 0.05). No recurrence was recorded during follow-up. Cure rate was significantly higher in the treat ment group than in the control group (94% vs. 85%, P < 0.05). Effectiveness was significantly better in the treatment group than in the control group ( P < 0
作者
陈显韬
宋小平
敬秀平
陈玉川
甘倩
Chen Xiantao;Song Xiaoping;Jing Xiuping;Chen Yuchuan;Gan Qian(Department of Anus & Intestine Surgery, West China-Guang’an Hospital, Sichuan University, Guang’an 638000, Sichuan, China;Teaching and Research Section of Basic Sciences, Guang’an Vocational & Technical College, Guang’an 638000, Sichuan, China)
出处
《结直肠肛门外科》
2019年第5期542-547,552,共7页
Journal of Colorectal & Anal Surgery
基金
四川省中医药管理局中医药科研专项课题（2018QN055）
关键词
环状混合痔
改良切开减压术
外剥内扎术
circumferential mixed hemorrhoids
Milligan-Morgan hemorrhoidectomy
modified open decompression
