痔上黏膜环形切除术与外痔切除术联合治疗混合痔临床疗效分析.docVIP

痔上黏膜环形切除术与外痔切除术联合治疗混合痔临床疗效分析 　　[摘要] 目的 分析痔上黏膜环形切除术与外痔切除术联合治疗混合痔的临床疗效。 方法 回顾性分析2012年1月～2014年1月期间来我院治疗的混合痔患者108例的临床资料，根据手术方式分为观察组和对照组。观察组患者54例采用痔上黏膜环形切除术与外痔切除术联合治疗。对照组患者54例采用传统的外剥内扎术治疗。观察两组患者的各项临床指标、术后3 d内的疼痛情况和术后6个月内的并发症发生情况。 结果 观察组患者手术时间、术中出血量、住院时间、住院费用均显著优于对照组患者，两组比较差异有统计学意义（P0.05）。观察组患者术后24 h、48 h、72 h的疼痛评分低于对照组患者，两组比较差异有统计学意义（P0.05），观察组患者术后24 h、48 h、72 h较对照组患者疼痛较轻。排除某一患者合并多种并发症情况，术后6个月内观察组患者术后并发症总发生率为18.51%，显著低于对照组患者的81.50%，差异有统计学意义（P0.05）。结论 痔上黏膜环形切除术与外痔切除术联合治疗混合痔效果好，术后疼痛程度轻、术后并发症少，可以在临床上进一步推广和使用。 　　[关键词] 痔上黏膜环形切除术；外痔切除术；联合；混合痔 　　[中图分类号] R657.1 [文献标识码] B [文章编号] 1673-9701（2015）11-0045-03 　　[Abstract] Objective To analyze the clinical effects of procedure for prolapse and hemorrhoids combined with external hemorrhoidectomy in the treatment of mixed hemorrhoid. Methods Clinical data of 108 patients with mix hemorrhoid who were admitted to our hospital from January 2012 to January 2014 were retrospectively analyzed. The 108 patients were assigned to an observation group and a control group according to the surgical procedures. 54 patients in the observation group received procedure for prolapse and hemorrhoids combined with external hemorrhoidectomy， and 54 patients in the control group received the conventional Milligan-Morgan operation. Each clinical index， pain conditions within 3 days after surgery and complications within 6 months after the surgery in the two groups were compared. Results Surgery time， amount of bleeding during surgery， hospitalization time， and hospitalization expenses in the observation group were all significantly better than those in the control group， and the differences were statistically significant（P 　　[Key words] Procedure for prolapse and hemorrhoids； External hemorrhoidectomy； Combined； Mix hemorrhoid 　　痔疮是常见的肛肠科疾病，是由肛管皮下静脉和直肠末端出现静脉曲张形成的团状物[1]，分为内痔、外痔和混合痔，其中混合痔是痔疮发展的最终阶段。临床上治疗混合痔的方法有很多，主要以手术治疗为主[2]。传统的手术方法为外剥内扎术，但这种手术方式术后的疼痛难以忍受、易发生肛门水肿，从而延长患者的住院时间，增加患者家庭的经济负担[3]。痔上黏膜环形切除术能够很好地解决传统手术带来的困扰，但也有一定的局限性，有报道证实，痔上黏膜环形切除术与外痔切除术联合治疗混合痔