摘要
目的分析内套外剥齿状线保留术治疗Ⅲ度混合痔的临床疗效。方法纳入上海中医药大学附属曙光医院肛肠科2016年9月至2016年12月行手术治疗的120例Ⅲ度混合痔患者为研究对象。按照随机数字表法,将患者分为两组,对照组(n=60,采用混合痔外剥内扎术)和治疗组(n=60,采用内套外剥齿状线保留术)。观察记录术后不同时间(第1、3、7、14天)患者疼痛、出血、肛缘或皮桥水肿、肛门坠胀、创面渗液、排便情况、发热、尿潴留等情况,创面愈合时间及有无肛门狭窄、肛门失禁、内痔脱出等症状。结果治疗组术后出血、疼痛、肛缘或皮桥水肿、创面渗液、排便困难程度轻于对照组,创面愈合时间短于对照组,肛门坠胀程度重于对照组,差异均有统计学意义(均P<0.05)。两组均无患者出现术后发热;仅对照组有1例患者出现尿潴留。两组均未出现肛门狭窄、肛门失禁、内痔脱出。结论内套外剥齿状线保留术治疗Ⅲ度混合痔,可以减轻术后临床症状、缩短创面愈合时间,具有一定的临床应用、推广价值。
Objectives To investigate the effect of dentate line-sparing combined with internal rubber band ligation and exter?nal dissection in treating gradeⅢmixed hemorrhoids.Methods A total of 120 patients with gradeⅢmixed hemorrhoids treat?ed at the Department of Anorectal Diseases,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,between September and December 2016 were randomly assigned to two groups by using a random number table.Patients in the control group(n=60)received the Milligan-Morgan technique,and patients in the treatment group(n=60)received dentate linesparing combined with internal rubber band ligation and external dissection.The following were recorded at 1,3,7,and 14 days after surgery:pain,bleeding,perianal or dermal bridge edema,the sensation of rectal tenesmus,wound oozing,bowel move?ment,fever,and urinary retention.Time to wound healing and occurrence of anal stricture,anal incontinence,and prolapse of in?ternal hemorrhoids were also recorded.Results Bleeding,pain,perianal or dermal bridge edema,wound oozing,and difficulty in defecation after surgery was significantly less,and time to wound healing was significantly shorter in the treatment group than in the control group(P<0.05).The sensation of rectal tenesmus was significantly more severe in the treatment group than in the con?trol group(P<0.05).No fever occurred after surgery.One patient in the control group experienced urinary retention.No anal stric?ture,anal incontinence,and prolapse of internal hemorrhoids were reported.Conclusion In patients with gradeⅢmixed hemor?rhoids,dentate line-sparing combined with internal rubber band ligation and external dissection can improve post-surgery symp?toms and shorten time to wound healing.It has the potential value to be applied in clinical practice.
作者
余肖
陆宏
张巍
彭云花
陈天
王清园
杨巍
Yu Xiao;Lu Hong;Zhang Wei;Peng Yunhua;Chen Tian;Wang Qingyuan;Yang Wei(Department of Anorectal Diseases,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,201203,China)
出处
《结直肠肛门外科》
2020年第2期202-207,212,共7页
Journal of Colorectal & Anal Surgery
基金
上海市科学技术委员会科研计划项目(16401971600)
上海市临床重点专科项目(shslczdzk04302)
国家自然科学基金项目(81673768)
杨巍上海市名老中医学术经验研究工作室(SHGZS-2017028)
上海市科学技术委员会科研计划项目(18401904600)。
关键词
混合痔
内套外剥齿状线保留术
外剥内扎术
mixed hemorrhoids
dentate line-sparing combined with internal rubber band ligation and external dissection
Milligan-Morgan technique
