PPH手术荷包缝合技术的临床探讨.docVIP

PPH手术荷包缝合技术的临床探讨 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：PPH手术荷包缝合技术的临床探讨 1 1 临床资料 2 2 讨 论 4 文2：PPH手术围手术期的护理 6 1资料与方法 6 参考文摘引言： 8 原创性声明（模板） 9 文章致谢（模板） 10 正文 PPH手术荷包缝合技术的临床探讨 文1：PPH手术荷包缝合技术的临床探讨 [Abstract] Objective To investigate a more ideal technique of puestring suture in procedure for prolapse and hemorrhoids (PPH). Methods A total of 183 cases of Ⅲ and Ⅳ degree prolapsed hemorrhoids were treated by PPH. Group A was with improved puestring suture and group B with unimproved puestring suture. Results For Ⅲdegree hemorrhoid, the indexes of width of excised rectum mucosal ring, the correction of prolaposed hemorrhoid in group A were significantly superior to that in group B, while the operation time, intraoperative abdominal pain, intraoperative bleeding, postoperative anal pain, postoperative anal bleeding and hospital stay showed no significant differences between two groups (P). For Ⅳdegree hemorrhoid, compared with group B, the indexes of the width of excised mucosal ring and the correction of the prolapsed hemorrhoid rate were significantly superior in group A（P）, but more intraoperative bleeding, more incidence of lower abdominal pain and postoperative anal pain, longer operation time were found in group A （P）. Conclusion For Ⅲdegree hemorrhoid, single puestring suture can reach the aim of treatment, but puestring suture technique should be mastered. For Ⅳdegree hemorrhoid or prolapse of rectum mucosal, double puestring suture are more suitable. [Key words] Internal hemorrhoid; Procedure for prolapse and hemorrhoids; Puestring suture PPH(procedure for prolapse and hemorrhoids)是近年来治疗痔病的重要进展之一。PPH虽然有诸多优点,但也有较多不足之处，如术中吻合口出血、下腹部疼痛，术后出血、肛门不适、残留皮赘或痔核脱垂。其原因与黏膜下荷包缝合有关。我院2006年1月至2006年12月施行PPH痔手术183例，现报告如下。 1 临床资料 一般资料 本组183例，男98例，女85例。年龄24～78岁（平均岁）,病程2～30年（平均年）。Ⅲ度112例，Ⅳ度71例，术前有内痔注射史9例（%），接受传统外剥内扎术者7例（%）,4例合并有直肠黏膜脱垂，脱垂长度为～ cm，平均 cm,伴有肛乳头肥大13例(%),伴肛裂17例( 术前准备 对病史及体查有怀疑者，行 电子 肠镜检查。术前行清洁灌肠。采用腰麻，取膀胱截石位，垫高臀部。 手术方法 早期进行手术的88例患者严格按照《吻合器痔上黏膜