痔上粘膜环切除术427例临床分析.docVIP

精品论文 参考文献 痔上粘膜环切除术427例临床分析 汪一兵 （黄山市人民医院普外科 245000） 【摘要】 目的 掌握应用吻合器痔上粘膜环切除术（PPH）手术适应症。方法 对黄山市人民医院普外科2002年1月至2012年10月应用PPH手术方法已完成的427例各种类型痔的病人进行随访、分析及比较手术后各种并发症，完成辅助手术情况，再发脱垂情况，结果 ①并发症：外痔组术后大出血1例，肛缘水肿13例，吻合口狭窄3例；内痔组术后大出血3例，肛缘水肿3例，吻合口狭窄4例；混合痔组术后大出血1例，肛缘水肿16例，吻合口狭窄7例。②辅助其他手术：外痔组辅助外痔切除35例，内痔套扎5例，外剥内扎11例，内痔组内痔套扎4例；混合痔组辅助外痔切除21例，内痔套扎术8例，外剥内扎6例。三组间差异有统计学意义（均P＜0.05）。③在随访一年以上的202例病人中共复发脱垂12例，约占5.5%。结论 PPH手术方式仍有一定复发率、并发症，手术应严格掌握手术适应症。 【关键词】 PPH手术 手术适应症 【中图分类号】R657.1+8【文献标识码】A【文章编号】2095-1752（2013）03-0129-02 Prcedure for prolapse and hemorrhoids:a clinical analysis of 427 cases Wang Yi-bing, huang shang people hospital general surgery 【Abstract】Objective To master indication of procedure for prolapse and hemorrhoids(PPH).Methods Four hundred and twenty-seven patients performed PPH between Jan 2002 and Dct 2012 at Hospital of general Surgery ,Huang Shang people hospital were followed up.Postoperative complications, assistant-operation completed information and prolapse reappeared state were analyzed retrospectively .Results (1)complications:there were 1 cases with hemorrhoea,13 cases with edge anus drosy and 3 cases Stenosis of stoma after operation in external hemorrhoid group.There were 3 cases with hemorrhoea, 3 cases with edge anus dropsy and 4 cases stenosis of stoma after operation in internal hemorrhoid group. And there were 1 cases with hemorrhoes, 17 cases with edge anus dropsy and 7 cases with stenosis of stoma after operation in mixed hemorrhoid group.(2) other aid operation: there were 35 cases to cut cutaneous hemorrhoids, 6 cases loop ligature internal hemorrhoids, 11 out peel and inside ligature in external hemorrhoid group. There were 4 cases loop ligature internal hemorrhoids. There were 21 cases to cut cutaneous hemorrhoid, 8 cases loop ligature internal hemorrhoids, 6 cases out peel and inside ligature in mixed hemorrhoid group(all P＜0.05).(3) More than 1 year of follow-up,12 of 202 patients with recurrent prolapse,accounting