摘要
目的探讨带蒂皮瓣推移的Milligan-Morgan术治疗环状混合痔的疗效。方法选择2018年5月至2019年5月我科收治的60例Ⅱ~Ⅳ度环状混合痔患者,随机分为研究组和对照组,各30例,分别行带蒂皮瓣推移的M-M术和皮桥不予处理的M-M术。结果术后D3和D7时研究组和对照组的疼痛VAS评分均较D0时明显降低,且研究组VAS评分均低于同期对照组,差异有统计学意义(P<0.01)。两组术后均无大出血和肛周血肿/血栓发生。研究组术后皮桥水肿与尿潴留的发生率均低于对照组,差异有统计学意义(P<0.05),而两组术后肛门坠胀发生率比较无统计学差异(P>0.05)。术后6个月研究组肛口残余皮赘数明显少于对照组,治愈率明显高于对照组,差异均有统计学意义(P<0.01)。结论带蒂皮瓣推移的Milligan-Morgan术治疗能有效减轻皮肤黏膜桥水肿和术后疼痛,提高混合痔的治愈率。
Objective To investigate the effect of Milligan-Morgan procedure with pedicled advance skin flap for circumferential mixed hemorrhoids.Methods A total of 60 cases suffered circumferential mixed hemorrhoids with gradeⅡtoⅣadmitted from May 2018 to May 2019 were enrolled and randomized into study group and control group,with 30 patients for each group.Milligan-Morgan procedure with pedicled advance skin flap was performed in the study group,and traditional Milligan-Morgan operation without skin bridge management was carried out in the control group.Results The VAS score of D3 and D7 was decreased than that of D0 in both study group and control group,and the VAS score was lower in the study group than that in the control group on D3 and D7,and all the differences were statistically(P<0.01).No hemorrhoea,perianal hematoma or thrombosis was found in both groups after the surgery.The incidence of postoperative cutaneous bridge edema and urinary retention was lower in the study group than that in the control group(P<0.05),but there was no significant difference in the incidence of fall-swell between the two groups(P>0.05).At 6 months after operation,the numbers of residual perianal cutaneous tag were less and the cure rate was higher in the study group than those in the control group,and all the differences were remarkable(P<0.01).Conclusion The surgery of Milligan-Morgan procedure with pedicled advance skin flap can relieve edema of skin bridge and postoperative pain effectively,and increase the cure rate of hemorrhoids obviously.
作者
杨海波
施展
何春锋
陈威
万文燕
丁培霖
YANG Hai-bo;SHI Zhan;HE Chun-feng;CHEN Wei;WAN Wen-yan;DING Pei-lin(Department of Anorectal Surgery, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China)
出处
《中国现代手术学杂志》
2021年第1期36-39,共4页
Chinese Journal of Modern Operative Surgery
基金
上海市卫生和计划生育委员会科研课题面上项目(编号:201740179)。
