吻合器痔上粘膜环切除术与Milligan-Morgan术治疗重度痔的对比研究
|
摘要
目的:探讨吻合器痔上粘膜环切除术与Milligan-Morgan术在治疗重度痔的临床效果。
方法:收集广西医科大学第一附属医院结直肠外科2003年11月至2006年11月,应用PPH术与MM术治疗128例重度痔患者的临床资料,结合随访研究两种术式患者的手术时间、住院天数、术中出血量、术后近期和远期并发症。
结果:手术时间PPH组(47.78±16.82min)短于MM组(61.14±18.93min),p＜0.01;住院天数PPH组(7.56±2.73d)少于MM组(9.95±3.41d),p＜0.01;术后当天和术后第1天PPH组疼痛发生率(59.4%和29.69%)均低于MM组(100%和95.31%),p＜0.01;术后第2天PPH组尿潴留有3例(4.69%),MM组有13例(20.31%),p＜0.01:肛门坠胀PPH组有11例(18.97%),MM组有3例(5.56%),p＜0.01;术后复发PPH组有6例(10.34%),MM组有2例(3.70%),(p＜0.01);PPH组无肛门狭窄,MM组有5例(9.26%),p＜0.01。
结论:PPH治疗重度痔,具有住院天数少、手术时间短、术中出血少、术后疼痛发生率低、恢复快和并发症少等优点,近期疗效肯定。Milligan-Morgan术治疗重度痔复发率较PPH低,远期疗效相对较好。
PURPOSE:To evaluate the efficiency and safety of procedure for prolapse and hemorrhoids and Milligan-Morgan hemorrhoidectomy.
METHODS:From November 2003 to November 2006,the clinical data of 128 patients who underwent hemorrhoidectomy were retrospectively reviewed:64 patients with PPH(group PPH)and 64 patients with Milligan-Morgan operations(group MM),in the Department of Colorectal and Anus Disease,the First Affiliated Hospital of Guangxi Medical University.Parameters investigated were hospitalization、operating time、intraopertive blooding and complications of the postoperative.
RESULTS:The total hospitalization time were(7.56±2.73)days in group PPH and(9.95±3.41)days in group MM respectively,there were significant statistical differences between the two groups (p＜0.01).The operation time of group PPH were shorter than the time of group MM,and they were(47.78±16.82min)and(61.14±18.93min)respectively(p＜0.01).The incidence rates of postoperative pain were 59.4%and 100%in the operating day respectively(p＜0.01).And the rates were 29.69%and 95.31% respectively in the first day after operation(p＜0.01)respectively in group PPH and group MM.The rate of urinary retention was 4.69% and 20.31%respectively in the second day after operation,and the rate of complaining bearing-down pain were 18.97%and 5.56% respectively in the two groups(p＜0.05).The recurrence rate were 10.34%and 3.70%respectively(p＜0.05).The rate of archostenosis were 9.26%in group MM,and it was none in group PPH(p＜0.05).
CONCLUSIONS:The advantages of PPH for hemorrhoids include shortening the hospitalization,reducing the time of operating, degrading to blood on operating,shortened convalescence,decreasing the postoperative pain and the postoperative complications.PPH is a safe and effective method in the treatment of prolapsed hemorrhoids. In a long-term,Milligan-Morgan hemorrhoidectomy has more advantages than PPH in hemorrhoid recurrence and prolapse.
方法:收集广西医科大学第一附属医院结直肠外科2003年11月至2006年11月,应用PPH术与MM术治疗128例重度痔患者的临床资料,结合随访研究两种术式患者的手术时间、住院天数、术中出血量、术后近期和远期并发症。
结果:手术时间PPH组(47.78±16.82min)短于MM组(61.14±18.93min),p＜0.01;住院天数PPH组(7.56±2.73d)少于MM组(9.95±3.41d),p＜0.01;术后当天和术后第1天PPH组疼痛发生率(59.4%和29.69%)均低于MM组(100%和95.31%),p＜0.01;术后第2天PPH组尿潴留有3例(4.69%),MM组有13例(20.31%),p＜0.01:肛门坠胀PPH组有11例(18.97%),MM组有3例(5.56%),p＜0.01;术后复发PPH组有6例(10.34%),MM组有2例(3.70%),(p＜0.01);PPH组无肛门狭窄,MM组有5例(9.26%),p＜0.01。
结论:PPH治疗重度痔,具有住院天数少、手术时间短、术中出血少、术后疼痛发生率低、恢复快和并发症少等优点,近期疗效肯定。Milligan-Morgan术治疗重度痔复发率较PPH低,远期疗效相对较好。
PURPOSE:To evaluate the efficiency and safety of procedure for prolapse and hemorrhoids and Milligan-Morgan hemorrhoidectomy.
METHODS:From November 2003 to November 2006,the clinical data of 128 patients who underwent hemorrhoidectomy were retrospectively reviewed:64 patients with PPH(group PPH)and 64 patients with Milligan-Morgan operations(group MM),in the Department of Colorectal and Anus Disease,the First Affiliated Hospital of Guangxi Medical University.Parameters investigated were hospitalization、operating time、intraopertive blooding and complications of the postoperative.
RESULTS:The total hospitalization time were(7.56±2.73)days in group PPH and(9.95±3.41)days in group MM respectively,there were significant statistical differences between the two groups (p＜0.01).The operation time of group PPH were shorter than the time of group MM,and they were(47.78±16.82min)and(61.14±18.93min)respectively(p＜0.01).The incidence rates of postoperative pain were 59.4%and 100%in the operating day respectively(p＜0.01).And the rates were 29.69%and 95.31% respectively in the first day after operation(p＜0.01)respectively in group PPH and group MM.The rate of urinary retention was 4.69% and 20.31%respectively in the second day after operation,and the rate of complaining bearing-down pain were 18.97%and 5.56% respectively in the two groups(p＜0.05).The recurrence rate were 10.34%and 3.70%respectively(p＜0.05).The rate of archostenosis were 9.26%in group MM,and it was none in group PPH(p＜0.05).
CONCLUSIONS:The advantages of PPH for hemorrhoids include shortening the hospitalization,reducing the time of operating, degrading to blood on operating,shortened convalescence,decreasing the postoperative pain and the postoperative complications.PPH is a safe and effective method in the treatment of prolapsed hemorrhoids. In a long-term,Milligan-Morgan hemorrhoidectomy has more advantages than PPH in hemorrhoid recurrence and prolapse.
引文
1 陈利生,高枫.痔的外科治疗。大肠肛门病外科杂志,2002,8(3):133-135。
2 Longo A.Treatment of Hemorrhoids disease by Reductionof mucosa and Hemorrhoidal Prolapse with a Circular Suturing Device:a new Procedure.Proceedings of the 6th.World Congress of Endoscopic Surgery[M].Bologna Munduzzi Editore,1998:777-784.
3 Thomson W HF.The nature of hemorrhoids.Br J Surg,1975,62(7):542-552.
4 陈哲.PPH已成为切除痔手术主流-访意大利著名肛肠科专家郎格博士[N].健康时报,2005,11(17):19.
5 姚礼庆,钟芸诗,孙益红,等.吻合器痔上粘膜环形切除术治疗重度痔疮的3年疗效评价.中华胃肠外科杂志,2004,7:120-122.
6 陈双,赖东明,等。吻合器痔上粘膜环切术治疗重度痔病226例疗效分析。岭南现代临床外科,2005,5(4):255.
7 Bikhchandani J Aganval PN,Kant R,et al.Randomized controlled trial to compare the early and midtemp results of stapled versus open hemorfioidectomy[J].Am J Sung,2005,189(1):56-60.
8 吕晨,邹建玲,沈淑华,等。视觉模拟量表和语言评价量表用于术后疼痛评估的比较.全科医学临床与教育,2004,4(2):215-219.
9 Parks AG.Haemorrhoids Hosp[J].Rep,1995,104:135-156.
10 THOMSON W H.The nature of hemorrhoids[J].Br J Surg,1975,62:542-552.
11 Longo A.Treatment of hemonrroids disease by reduction of mucosa and hemorroidal prolapse with a circular suturing device:a new procedure.Proceedings of the 6th world congress of endoscopic surgery.Rome.Italy,1998,3(6):777-784.
12 Milligan ETC,Morgan CN,Jones LE,et al.Surgical Anatomy ofthe Anal Canal,and the operation Treatment of Hemorrhoids[J].Lanct,1937,223:1119-1124.
13 Pope V,Doran H,Fearn S,et al.Randomised,controllec trial comparing quality of life after open henmorrhoidectomy(OH)plus stapled anopexy(SA).Dis Colon Rectum,2002,44(4):5.
14 洪楚原,胡以则.吻合器痔上粘膜环切术治疗痔病[J].中华中医学杂志,2001,25(5):277-278.
15 傅传刚.痔手术治疗的术式演变.中国实用外科杂志,2001,21(11):686-688.
16 傅传刚,张卫,王汉涛,等.吻合器环行痔切除术.中国实用外科志,2001,21(11):653-655.
17 楼文晖.环状吻合器痔环切术和Milligan_Morgan痔切除术后2年的疗效比较.中华医学杂志,2005,85(30):2156.
18 张红,席亚鸣,王华曦,等.痔上粘膜环行切除术与Milligan_Morgan 术对重度痔治疗的比较.暨南大学学报,2003,24(4):41-45.
19 严建,袁轶峰。PPH术与Milligan-Morgan术治疗重度混合痔的疗效比较.中医药导报,2007,13(5):63-64.
20 Rowsell M,Bdlo M,Hemingway DM.Circumferential mucosectomy (stapled haemorrhoi-dectomy)versus conventional haemorrhoidectomy:randomized controlled trial.Lancet,2000,355:779-781.
21 Rowsell M,Bello M,Hemingway D.Circumferential mucosectomy versus conventional haemorrhoidectomy:randomized controlled trial.Lancet.2000,355:779-781.
22 洪楚原.浅谈吻合痔上粘膜环切术治疗治病[J].广东医学,2001,22(12):1094-1096.
23 Longo A.Treatment of hemorrhoids disease by reduction of mucosa and haemorhodial prolapse with acircular suturing device:a new proedure.Proceedings of the 6th World Congress of Endoscopic Surgery.Rome,1998,3(6):777-784.
24 洪楚原.浅谈吻合器痔上粘膜环切术治疗痔病[J].广东医学,2001,22(12):1094-1096.
25 王辉,唐伟漂,肖焕擎。PPH对Ⅲ~0～Ⅳ~0痔病治疗的术后并发症及对策[J].大肠肛门病外科杂志,2003,9(增刊):17-20.
26 姚礼庆.吻合器治疗重度痔(60例报告).中国微创外科杂志,2000,1:268-269.
27 赵顺.张德枫,赵乐平,等.吻合器治疗重度痔32例临床观察。大肠肛门病外科杂志,2004,10(4):302-303.
28 傅传刚,张卫,王汉涛,等.直肠下端粘膜环行切除肛垫悬吊术治疗脱垂性内痔.中华普通外科杂志,2002,17(2):112-113.
29 陈双,赖东明,周太成,等.吻合器痔上粘膜环切术治疗重度痔病226例疗效分析.岭南现代临床外科,2005,5(4):255-257.
30 范应方,黄宗海,方驰华.PPH术和Milligan术治疗重度痔142例临床比较分析.中华现代外科学杂志,2005,2(4):295-297.
31 兰平,周旭毓,吴小剑,等.吻合器痔上粘膜环形切除术与Milligan-Morgan术的安全性和有效性随机对照研究的系统评价.中华胃肠外科杂志,2004,7(4):262-266.
32 Ganio E,Aitomare DF,Gabrielli F,et al.Prospective randomized muhicentre trial comparing stapled with open hemorrhoidectomy [J].Br J Surg,2001,88:669-674.
33 Beattie GC.Loudon MA.Circumferential stapled anoplasty in the management of haemorrhoids and mucosal prolapse.Coloreetal Disease,2000,2(3):170-175.
34 Milligan ETC,Morgan CN,Jones LE,et al.Surgical anatomy of the anal canal,and the operation treatment of hemorrhoids[J].Lancet,1937,233:1119-1224.
35 MacRae HM,Mcleod Rs.Comparison of hemorrhoidal treatment modaliltes.A Meta Analysis[J].Dis Colon Rectum,1995,38(7):687-694.
36 姚礼庆,钟芸诗,孙益红,等。吻合器痔上粘膜环形切除术治疗重度痔疮的3年疗效评价[J].中华胃肠外科杂志,2004,7(2):120-123.
37 傅传刚.吻合器环形痔切除术.中国肛肠病杂志,2002:22(3):32-34.
38 Racalbuto A,Aliotta I,Corsao G,et al.Hemordaoidal stapler prolapsectomyvs Milligan-Morgan hemorrhoidectory:along term randomized trial[J].Int J Coloreetal Dis,2004,19(3):239.
39 KirschJJ,StaudeG,Herold A.The Longo and Milligan-Morgan hemorrhoideetomy.A prospective comparative study of 300patients[J].Chirurg,2001,72(2):180.
40 Nisar PJ,et al.Dis Colon rectum,2004(11):1837-1845.
41 杨琴燕,杨关根,孙鸿斌,等.痔病PPH术后肛肠动力学变化.浙江中西医结合杂志,2007,17(1):44-45.
42 贾振理,朱子宜,宋伟,等.不同术式治疗Ⅲ-Ⅳ期痔复发率的比较.浙江中西医结合杂志,2007,17(11):715-716.
43 陈飞燕.国产吻合器痔切闭术与Milligan—Morgan术治疗Ⅲ-Ⅳ度痔的对比研究.中国中西医结合外科杂志,2005,11(1):17-19.
44 赵江宁.Ⅲ-Ⅳ度痔的PPH治疗[J].广东医学,2001,22(12):1059-1097.
1 Longo A.Treatment of hemorrhoids disease by reduction of mucosa and hemorrhoidal prolapse with a circular suturing device:a new procedure.Rome,Italy:Proceedings of the 6th.World Congress of Endoscopic Surgery,1998.
2 杨新庆.解读《痔诊治暂行标准》.中华全科医师杂志2005,4(7):406-407。
3 LONGO A.Treatment of Hemorrhoids Disease by Reductionof Mucosa and Hemorrhoidal Prolapse with a Circular Suturing Device:a new Procedure.Proceedings of the 6th World Congress of Endoscopic Surgery[M].Bologna:Munduzzi Editore,1998:777-784.
4 Thomson WH.The nature of hemorrhoids[J].Br J Surg,1975,62(7):542.
5 Lord PB,Kamnn MA,Nickols RJ,et al.Hemorhoids:pathology pathophsiology and etiology[J].Br J Surg,1994,81(7):946.
6 Peseatori M,Favetta U,Dedola S,et al.Trananal stapled excision of rectal mucosal prolapse Tech in Colopcroctol,1997,1:96-98.
7 Longo A.Treatment of hemonrroids disease by reduction of mucosa and hemorroidal prolapse with a circular suturing device:a new procedure.Proceedings of the 6th world congress of endoscopic surgery.Rome.Italy,1998,3(6):777-784.
8 中华医学会外科学分会肛肠外科学组.《痔上粘膜环形切除钉合术(PPH)暂行规范》修订。中华外科杂志,2005,8(4):342。
9 中华医学会外科分会肛肠外科组。《痔上粘膜环形切除钉合术(PPH)暂行规范》修订.中华胃肠外科杂志,2005,8(4):374。
10 傅传刚,丁健华.PPH术治疗痔病的适应证与注意事项[J].大肠肛门病外科志杂,2003,9(3):151。
11 Havrylenko SP.Results of the surgincal treatment of acute hemorrhoidal thrombosis.Klin Khir,1998,(4):28-29.
12 Yik-Hong Ho,FRACS,Wai-Kit Cheong,et al.Stapled Hemorrhoidectomy cost and Effectiveness.Dis Colon Rectum,2000,43:1666-1675.
13 傅传刚,张卫,王汉涛,等。吻合器环形痔切除术[J],中国实用外科杂志,2001,21(11):653.
14 张振勇,张宽,蔡碧波,等.局麻下实施PPH术的可行性研究[J].大肠肛门病外科杂志,2003,9(增刊):40-41。
15 姚礼庆.吻合器痔上粘膜环形切除术治疗重度痔疮的3年疗效评价[J].中华胃肠外科杂志,2004,3(7):120-124.
16 傅传刚.重视PPH在痔治疗中的合理应用[J].中国实用外科杂志,2007,27(6):436-437.
17 李胜龙,尹廷宝,鲍铭,等,对“《PPH暂行规范》修订”的探讨.中国普外基础与临床杂志,2007,14,(3):362-363.
18 秦海.吻合器环形痔切除术治疗脱垂痔.中国城乡企业卫生,2004,6,3(101):27-28.
19 姜华,汤献忠.吻合器痔上粘膜环切术(PPH)国内应用现状。广西中医学院学报,2006,9(3):93-95.
20 洪楚原。浅谈吻合器痔上粘膜环切术治疗痔病[J].广东医学,2001,22(12):1094-1096.
21 傅传刚,丁健华.PPH术治疗痔病的适合证与注意事项.大肠肛门外科杂志,2003,9(3):151。
22 陈朝文.PPH治疗脱垂痔的新方法.中国微创外科杂,2001, 1(5):315-316.
23 司徒光伟.PPH技术治疗痔231例术后观察[J].人肠肛门病外科杂志,2003,9(4):239-240。
24 姚礼庆,钟芸诗,孙益红,等.吻合器痔上粘膜环形切除术治疗重度痔疮的3年疗效评价[J]。中华胃肠外科杂志,2004,7(2):120-123。
25 刘振邦,王辉,肖焕肇.吻合器痔上粘膜环形切除术术后并发症的处理对策[J].岭南现代临床外科,2005,5,(1):36-38.
26 Rowsell M,Bello M,Hemingway DM.Circumferential mucosectomy (stapled haemorrhoidectomy)versus conventional haemorrhoidectomy:Ramdomised controlled trial.Lancet,2000,355(9206):779-781.
27 秦海.吻合器环形痔切除术治疗脱垂痔。中国城乡企业卫生,2004,6,3(101):27-28。
28 傅传刚,张卫,王汉涛,等.吻合器环形痔切除术[J].中国实用外科杂志,2001,21(11):653.
29 Petersen S,Hellmich G,Schumann D,et al.Early rectal stenosis following stapled rectal mucosectomy for hemorrhoids[J].BMC Surg,2004,21(4):6.
30 田勇,谭纪伏,赵斌。PPH在Ⅲ-Ⅳ度混合痔治疗中的应用研究[J].中华实用中西医杂志,2005,18(10):1512-1513,
2 Longo A.Treatment of Hemorrhoids disease by Reductionof mucosa and Hemorrhoidal Prolapse with a Circular Suturing Device:a new Procedure.Proceedings of the 6th.World Congress of Endoscopic Surgery[M].Bologna Munduzzi Editore,1998:777-784.
3 Thomson W HF.The nature of hemorrhoids.Br J Surg,1975,62(7):542-552.
4 陈哲.PPH已成为切除痔手术主流-访意大利著名肛肠科专家郎格博士[N].健康时报,2005,11(17):19.
5 姚礼庆,钟芸诗,孙益红,等.吻合器痔上粘膜环形切除术治疗重度痔疮的3年疗效评价.中华胃肠外科杂志,2004,7:120-122.
6 陈双,赖东明,等。吻合器痔上粘膜环切术治疗重度痔病226例疗效分析。岭南现代临床外科,2005,5(4):255.
7 Bikhchandani J Aganval PN,Kant R,et al.Randomized controlled trial to compare the early and midtemp results of stapled versus open hemorfioidectomy[J].Am J Sung,2005,189(1):56-60.
8 吕晨,邹建玲,沈淑华,等。视觉模拟量表和语言评价量表用于术后疼痛评估的比较.全科医学临床与教育,2004,4(2):215-219.
9 Parks AG.Haemorrhoids Hosp[J].Rep,1995,104:135-156.
10 THOMSON W H.The nature of hemorrhoids[J].Br J Surg,1975,62:542-552.
11 Longo A.Treatment of hemonrroids disease by reduction of mucosa and hemorroidal prolapse with a circular suturing device:a new procedure.Proceedings of the 6th world congress of endoscopic surgery.Rome.Italy,1998,3(6):777-784.
12 Milligan ETC,Morgan CN,Jones LE,et al.Surgical Anatomy ofthe Anal Canal,and the operation Treatment of Hemorrhoids[J].Lanct,1937,223:1119-1124.
13 Pope V,Doran H,Fearn S,et al.Randomised,controllec trial comparing quality of life after open henmorrhoidectomy(OH)plus stapled anopexy(SA).Dis Colon Rectum,2002,44(4):5.
14 洪楚原,胡以则.吻合器痔上粘膜环切术治疗痔病[J].中华中医学杂志,2001,25(5):277-278.
15 傅传刚.痔手术治疗的术式演变.中国实用外科杂志,2001,21(11):686-688.
16 傅传刚,张卫,王汉涛,等.吻合器环行痔切除术.中国实用外科志,2001,21(11):653-655.
17 楼文晖.环状吻合器痔环切术和Milligan_Morgan痔切除术后2年的疗效比较.中华医学杂志,2005,85(30):2156.
18 张红,席亚鸣,王华曦,等.痔上粘膜环行切除术与Milligan_Morgan 术对重度痔治疗的比较.暨南大学学报,2003,24(4):41-45.
19 严建,袁轶峰。PPH术与Milligan-Morgan术治疗重度混合痔的疗效比较.中医药导报,2007,13(5):63-64.
20 Rowsell M,Bdlo M,Hemingway DM.Circumferential mucosectomy (stapled haemorrhoi-dectomy)versus conventional haemorrhoidectomy:randomized controlled trial.Lancet,2000,355:779-781.
21 Rowsell M,Bello M,Hemingway D.Circumferential mucosectomy versus conventional haemorrhoidectomy:randomized controlled trial.Lancet.2000,355:779-781.
22 洪楚原.浅谈吻合痔上粘膜环切术治疗治病[J].广东医学,2001,22(12):1094-1096.
23 Longo A.Treatment of hemorrhoids disease by reduction of mucosa and haemorhodial prolapse with acircular suturing device:a new proedure.Proceedings of the 6th World Congress of Endoscopic Surgery.Rome,1998,3(6):777-784.
24 洪楚原.浅谈吻合器痔上粘膜环切术治疗痔病[J].广东医学,2001,22(12):1094-1096.
25 王辉,唐伟漂,肖焕擎。PPH对Ⅲ~0～Ⅳ~0痔病治疗的术后并发症及对策[J].大肠肛门病外科杂志,2003,9(增刊):17-20.
26 姚礼庆.吻合器治疗重度痔(60例报告).中国微创外科杂志,2000,1:268-269.
27 赵顺.张德枫,赵乐平,等.吻合器治疗重度痔32例临床观察。大肠肛门病外科杂志,2004,10(4):302-303.
28 傅传刚,张卫,王汉涛,等.直肠下端粘膜环行切除肛垫悬吊术治疗脱垂性内痔.中华普通外科杂志,2002,17(2):112-113.
29 陈双,赖东明,周太成,等.吻合器痔上粘膜环切术治疗重度痔病226例疗效分析.岭南现代临床外科,2005,5(4):255-257.
30 范应方,黄宗海,方驰华.PPH术和Milligan术治疗重度痔142例临床比较分析.中华现代外科学杂志,2005,2(4):295-297.
31 兰平,周旭毓,吴小剑,等.吻合器痔上粘膜环形切除术与Milligan-Morgan术的安全性和有效性随机对照研究的系统评价.中华胃肠外科杂志,2004,7(4):262-266.
32 Ganio E,Aitomare DF,Gabrielli F,et al.Prospective randomized muhicentre trial comparing stapled with open hemorrhoidectomy [J].Br J Surg,2001,88:669-674.
33 Beattie GC.Loudon MA.Circumferential stapled anoplasty in the management of haemorrhoids and mucosal prolapse.Coloreetal Disease,2000,2(3):170-175.
34 Milligan ETC,Morgan CN,Jones LE,et al.Surgical anatomy of the anal canal,and the operation treatment of hemorrhoids[J].Lancet,1937,233:1119-1224.
35 MacRae HM,Mcleod Rs.Comparison of hemorrhoidal treatment modaliltes.A Meta Analysis[J].Dis Colon Rectum,1995,38(7):687-694.
36 姚礼庆,钟芸诗,孙益红,等。吻合器痔上粘膜环形切除术治疗重度痔疮的3年疗效评价[J].中华胃肠外科杂志,2004,7(2):120-123.
37 傅传刚.吻合器环形痔切除术.中国肛肠病杂志,2002:22(3):32-34.
38 Racalbuto A,Aliotta I,Corsao G,et al.Hemordaoidal stapler prolapsectomyvs Milligan-Morgan hemorrhoidectory:along term randomized trial[J].Int J Coloreetal Dis,2004,19(3):239.
39 KirschJJ,StaudeG,Herold A.The Longo and Milligan-Morgan hemorrhoideetomy.A prospective comparative study of 300patients[J].Chirurg,2001,72(2):180.
40 Nisar PJ,et al.Dis Colon rectum,2004(11):1837-1845.
41 杨琴燕,杨关根,孙鸿斌,等.痔病PPH术后肛肠动力学变化.浙江中西医结合杂志,2007,17(1):44-45.
42 贾振理,朱子宜,宋伟,等.不同术式治疗Ⅲ-Ⅳ期痔复发率的比较.浙江中西医结合杂志,2007,17(11):715-716.
43 陈飞燕.国产吻合器痔切闭术与Milligan—Morgan术治疗Ⅲ-Ⅳ度痔的对比研究.中国中西医结合外科杂志,2005,11(1):17-19.
44 赵江宁.Ⅲ-Ⅳ度痔的PPH治疗[J].广东医学,2001,22(12):1059-1097.
1 Longo A.Treatment of hemorrhoids disease by reduction of mucosa and hemorrhoidal prolapse with a circular suturing device:a new procedure.Rome,Italy:Proceedings of the 6th.World Congress of Endoscopic Surgery,1998.
2 杨新庆.解读《痔诊治暂行标准》.中华全科医师杂志2005,4(7):406-407。
3 LONGO A.Treatment of Hemorrhoids Disease by Reductionof Mucosa and Hemorrhoidal Prolapse with a Circular Suturing Device:a new Procedure.Proceedings of the 6th World Congress of Endoscopic Surgery[M].Bologna:Munduzzi Editore,1998:777-784.
4 Thomson WH.The nature of hemorrhoids[J].Br J Surg,1975,62(7):542.
5 Lord PB,Kamnn MA,Nickols RJ,et al.Hemorhoids:pathology pathophsiology and etiology[J].Br J Surg,1994,81(7):946.
6 Peseatori M,Favetta U,Dedola S,et al.Trananal stapled excision of rectal mucosal prolapse Tech in Colopcroctol,1997,1:96-98.
7 Longo A.Treatment of hemonrroids disease by reduction of mucosa and hemorroidal prolapse with a circular suturing device:a new procedure.Proceedings of the 6th world congress of endoscopic surgery.Rome.Italy,1998,3(6):777-784.
8 中华医学会外科学分会肛肠外科学组.《痔上粘膜环形切除钉合术(PPH)暂行规范》修订。中华外科杂志,2005,8(4):342。
9 中华医学会外科分会肛肠外科组。《痔上粘膜环形切除钉合术(PPH)暂行规范》修订.中华胃肠外科杂志,2005,8(4):374。
10 傅传刚,丁健华.PPH术治疗痔病的适应证与注意事项[J].大肠肛门病外科志杂,2003,9(3):151。
11 Havrylenko SP.Results of the surgincal treatment of acute hemorrhoidal thrombosis.Klin Khir,1998,(4):28-29.
12 Yik-Hong Ho,FRACS,Wai-Kit Cheong,et al.Stapled Hemorrhoidectomy cost and Effectiveness.Dis Colon Rectum,2000,43:1666-1675.
13 傅传刚,张卫,王汉涛,等。吻合器环形痔切除术[J],中国实用外科杂志,2001,21(11):653.
14 张振勇,张宽,蔡碧波,等.局麻下实施PPH术的可行性研究[J].大肠肛门病外科杂志,2003,9(增刊):40-41。
15 姚礼庆.吻合器痔上粘膜环形切除术治疗重度痔疮的3年疗效评价[J].中华胃肠外科杂志,2004,3(7):120-124.
16 傅传刚.重视PPH在痔治疗中的合理应用[J].中国实用外科杂志,2007,27(6):436-437.
17 李胜龙,尹廷宝,鲍铭,等,对“《PPH暂行规范》修订”的探讨.中国普外基础与临床杂志,2007,14,(3):362-363.
18 秦海.吻合器环形痔切除术治疗脱垂痔.中国城乡企业卫生,2004,6,3(101):27-28.
19 姜华,汤献忠.吻合器痔上粘膜环切术(PPH)国内应用现状。广西中医学院学报,2006,9(3):93-95.
20 洪楚原。浅谈吻合器痔上粘膜环切术治疗痔病[J].广东医学,2001,22(12):1094-1096.
21 傅传刚,丁健华.PPH术治疗痔病的适合证与注意事项.大肠肛门外科杂志,2003,9(3):151。
22 陈朝文.PPH治疗脱垂痔的新方法.中国微创外科杂,2001, 1(5):315-316.
23 司徒光伟.PPH技术治疗痔231例术后观察[J].人肠肛门病外科杂志,2003,9(4):239-240。
24 姚礼庆,钟芸诗,孙益红,等.吻合器痔上粘膜环形切除术治疗重度痔疮的3年疗效评价[J]。中华胃肠外科杂志,2004,7(2):120-123。
25 刘振邦,王辉,肖焕肇.吻合器痔上粘膜环形切除术术后并发症的处理对策[J].岭南现代临床外科,2005,5,(1):36-38.
26 Rowsell M,Bello M,Hemingway DM.Circumferential mucosectomy (stapled haemorrhoidectomy)versus conventional haemorrhoidectomy:Ramdomised controlled trial.Lancet,2000,355(9206):779-781.
27 秦海.吻合器环形痔切除术治疗脱垂痔。中国城乡企业卫生,2004,6,3(101):27-28。
28 傅传刚,张卫,王汉涛,等.吻合器环形痔切除术[J].中国实用外科杂志,2001,21(11):653.
29 Petersen S,Hellmich G,Schumann D,et al.Early rectal stenosis following stapled rectal mucosectomy for hemorrhoids[J].BMC Surg,2004,21(4):6.
30 田勇,谭纪伏,赵斌。PPH在Ⅲ-Ⅳ度混合痔治疗中的应用研究[J].中华实用中西医杂志,2005,18(10):1512-1513,
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |