比较分析吻合器痔上粘膜环切术与传统切除术治疗痔疮的临床效果
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摘要
目的:针对痔疮治疗而言,关于传统切除术以及吻合器痔上粘膜环切术予以综合对比,进而给出两者表现出来的痔疮临床治疗实效性。方法:针对某院收治的2016年5月～2018年4月的痔疮患者(120例)予以综合比对,根据随机抽签法分为两组,即对照组(n=60)、观察组(n=60)。对照组患者应用传统切除术治疗,观察组患者应用吻合器痔上粘膜环切术治疗。与此同时,针对患有痔疮的上述患者而言,分别对比探析患者表现出来的手术时间长度、痔疮的临床疗效、切口愈合的总时间以及术中的患者出血量,并且对比并发症的出现概率。结果:相比于对照组,观察组呈现了更优的临床总有效率,其中差异具有统计学意义(P<0.05)。结论:吻合器痔上粘膜环切术相比而言具备了更优的痔疮治疗实效性,这是由于运用该手术方式有助于尽快愈合痔疮患者切口,对于术中的患者出血总量能够予以有序减少。在此前提下,针对上述的环切术方式应当予以推广。
Objective: To compare and analyze the clinical effect of procedure for prolapse and hemorrhoids(PPH) and traditional hemorrhoid resection in the treatment of hemorrhoids, then give the clinical effectiveness of hemorrhoids treatments showed by both. Methods: 120 patients with hemorrhoids admitted to a hospital from May 2016 to April 2018 were compared comprehensively and divided into the control group(n=60) and the observation group(n=60) according to the random lottery method. Control group was given traditional resection treatment. Observation group was given stapling hemorrhoids mucosa fibrotomy treatment, the clinical efficacy, operation time, intraoperative blood loss, incision healing time and complications of two groups were statistically compared. Results: Compared with the control group, the observation group presented a better clinical total effective rate, and the difference was statistically significant(P<0.05). Conclusion: Procedure for prolapse and hemorrhoids(PPH) has better effectiveness in hemorrhoid treatment. It can effectively speed up the healing of incision, and reduce the occurrence of complications, which is worth in clinical application and promotion.
Objective: To compare and analyze the clinical effect of procedure for prolapse and hemorrhoids(PPH) and traditional hemorrhoid resection in the treatment of hemorrhoids, then give the clinical effectiveness of hemorrhoids treatments showed by both. Methods: 120 patients with hemorrhoids admitted to a hospital from May 2016 to April 2018 were compared comprehensively and divided into the control group(n=60) and the observation group(n=60) according to the random lottery method. Control group was given traditional resection treatment. Observation group was given stapling hemorrhoids mucosa fibrotomy treatment, the clinical efficacy, operation time, intraoperative blood loss, incision healing time and complications of two groups were statistically compared. Results: Compared with the control group, the observation group presented a better clinical total effective rate, and the difference was statistically significant(P<0.05). Conclusion: Procedure for prolapse and hemorrhoids(PPH) has better effectiveness in hemorrhoid treatment. It can effectively speed up the healing of incision, and reduce the occurrence of complications, which is worth in clinical application and promotion.
引文
1 李胜.痔疮的发病与治疗综述.中国医药指南,2014,12(1):43～44.
2 王国强.吻合器痔上黏膜环切术的近远期疗效及安全性的Meta分析.新疆医科大学,2014.
3 Watson A J M,Hudson J,Wood J,et al.Comparison of Stapled Haemorrhoidopexy with Traditional Excisional Surgery for Haemorrhoidal Disease (eTHoS):A Pragmatic,Multicentre,Randomised Controlled Trial.The Lancet,2016,388(10058):2375～2385.
4 康宝君.吻合器痔上黏膜环切术联合外痔切除术治疗重度混合痔的临床观察.中国继续医学教育,2015,7(3):78～79.
5 Sirivongs P,Thiengthiantham R.Short-and Long-term 5-year Clinical Outcomes of Doppler-guided Hemorrhoidal Artery Ligation and Rectoanal Repair.Vajira Medical Journal,2017,60(1):5～14.
6 杨博,杨润清,张忠伟,等.吻合器痔上黏膜环切术与直肠黏膜柱状缝扎术治疗出口梗阻型便秘的临床疗效对比.新疆医科大学学报,2016,39(4):464～467.
7 Lu M,Yang B,Liu Y,et al.Procedure for Prolapse and Hemorrhoids vs Traditional Surgery for Outlet Obstructive Constipation.World Journal of Gastroenterology:WJG,2015,21(26):8178.
8 李志刚,于金辉,李明颖,等.骶管麻醉联合地西泮,阿托品预处理对择期吻合器痔上黏膜环切术患者生命体征,牵拉反射及疼痛的影响.实用药物与临床,2018,21(3):289～292.
9 Naldini G,Fabiani B,Menconi C,et al.Tailored Prolapse Surgery for the Treatment of Hemorrhoids with a New Dedicated Device:TST Starr Plus.International Journal of Colorectal Disease,2015,30(12):1723～1728.
10 李文第.吻合器痔上粘膜环切术与传统痔疮切除术治疗痔疮的疗效对比.中国实用医药,2016 (15):125～126.
11 Scheyer M,Antonietti E,Rollinger G,et al.Hemorrhoidal Artery Ligation (HAL) and Rectoanal Repair (RAR):Retrospective Analysis of 408 Patients in a Single Center.Techniques in Coloproctology,2015,19(1):5～9.
12 Kozan R,Y1 lmaz T U.Early Outcomes in Patients Treated with Stapled Hemorrhoidopexy.ISTANBUL MEDICAL JOURNAL,2017,18(2):68～71.
13 李莉,刘晖,高卫峰,等.吻合器痔上黏膜环切术加外痔剥除术治疗混合痔的临床体会.吉林医学,2015,36(3):428～429.
14 杨荣.吻合器痔上黏膜环切术治疗重度痔疮的临床观察.当代医学,2015,21(16):102～103.
15 吕时来,林国乐,李生贵,等.单双荷包缝合技术行吻合器痔上黏膜环切术治疗重度痔的对比研究.中国现代手术学杂志,2015 (1):10～13.
16 陈喜志,王运红,蓝活.吻合器痔上粘膜环切术与外剥内扎术治疗Ⅲ、Ⅳ度内痔的疗效比较.现代医院,2014,14(5):24～26.
17 杨钦清,董芳,梁顺华,等.吻合器痔上黏膜环切术(PPH)与传统外剥内扎术治疗环状混合痔的疗效比较.中国现代医生,2015,53(10):24～26.
18 李国文,曾山崎,陈转鹏,等.吻合器痔上黏膜环切术联合Ligasure痔切除术治疗重度混合痔的疗效观察.中华临床医师杂志(电子版),2014,1(1):50～53.
19 黄展易,杨昌谋,郭俊宇.吻合器痔上黏膜环切术联合消痔灵注射治疗直肠黏膜内套叠的临床疗效.现代医药卫生,2016,32(19):3017～3019.
20 Naldini G,Martellucci J,Rea R,et al.Tailored Prolapse Surgery for the Treatment of Haemorrhoids and Obstructed Defecation Syndrome with a New Dedicated Device:TST STARR Plus.International Journal of Colorectal Disease,2014,29(5):623～629.
2 王国强.吻合器痔上黏膜环切术的近远期疗效及安全性的Meta分析.新疆医科大学,2014.
3 Watson A J M,Hudson J,Wood J,et al.Comparison of Stapled Haemorrhoidopexy with Traditional Excisional Surgery for Haemorrhoidal Disease (eTHoS):A Pragmatic,Multicentre,Randomised Controlled Trial.The Lancet,2016,388(10058):2375～2385.
4 康宝君.吻合器痔上黏膜环切术联合外痔切除术治疗重度混合痔的临床观察.中国继续医学教育,2015,7(3):78～79.
5 Sirivongs P,Thiengthiantham R.Short-and Long-term 5-year Clinical Outcomes of Doppler-guided Hemorrhoidal Artery Ligation and Rectoanal Repair.Vajira Medical Journal,2017,60(1):5～14.
6 杨博,杨润清,张忠伟,等.吻合器痔上黏膜环切术与直肠黏膜柱状缝扎术治疗出口梗阻型便秘的临床疗效对比.新疆医科大学学报,2016,39(4):464～467.
7 Lu M,Yang B,Liu Y,et al.Procedure for Prolapse and Hemorrhoids vs Traditional Surgery for Outlet Obstructive Constipation.World Journal of Gastroenterology:WJG,2015,21(26):8178.
8 李志刚,于金辉,李明颖,等.骶管麻醉联合地西泮,阿托品预处理对择期吻合器痔上黏膜环切术患者生命体征,牵拉反射及疼痛的影响.实用药物与临床,2018,21(3):289～292.
9 Naldini G,Fabiani B,Menconi C,et al.Tailored Prolapse Surgery for the Treatment of Hemorrhoids with a New Dedicated Device:TST Starr Plus.International Journal of Colorectal Disease,2015,30(12):1723～1728.
10 李文第.吻合器痔上粘膜环切术与传统痔疮切除术治疗痔疮的疗效对比.中国实用医药,2016 (15):125～126.
11 Scheyer M,Antonietti E,Rollinger G,et al.Hemorrhoidal Artery Ligation (HAL) and Rectoanal Repair (RAR):Retrospective Analysis of 408 Patients in a Single Center.Techniques in Coloproctology,2015,19(1):5～9.
12 Kozan R,Y1 lmaz T U.Early Outcomes in Patients Treated with Stapled Hemorrhoidopexy.ISTANBUL MEDICAL JOURNAL,2017,18(2):68～71.
13 李莉,刘晖,高卫峰,等.吻合器痔上黏膜环切术加外痔剥除术治疗混合痔的临床体会.吉林医学,2015,36(3):428～429.
14 杨荣.吻合器痔上黏膜环切术治疗重度痔疮的临床观察.当代医学,2015,21(16):102～103.
15 吕时来,林国乐,李生贵,等.单双荷包缝合技术行吻合器痔上黏膜环切术治疗重度痔的对比研究.中国现代手术学杂志,2015 (1):10～13.
16 陈喜志,王运红,蓝活.吻合器痔上粘膜环切术与外剥内扎术治疗Ⅲ、Ⅳ度内痔的疗效比较.现代医院,2014,14(5):24～26.
17 杨钦清,董芳,梁顺华,等.吻合器痔上黏膜环切术(PPH)与传统外剥内扎术治疗环状混合痔的疗效比较.中国现代医生,2015,53(10):24～26.
18 李国文,曾山崎,陈转鹏,等.吻合器痔上黏膜环切术联合Ligasure痔切除术治疗重度混合痔的疗效观察.中华临床医师杂志(电子版),2014,1(1):50～53.
19 黄展易,杨昌谋,郭俊宇.吻合器痔上黏膜环切术联合消痔灵注射治疗直肠黏膜内套叠的临床疗效.现代医药卫生,2016,32(19):3017～3019.
20 Naldini G,Martellucci J,Rea R,et al.Tailored Prolapse Surgery for the Treatment of Haemorrhoids and Obstructed Defecation Syndrome with a New Dedicated Device:TST STARR Plus.International Journal of Colorectal Disease,2014,29(5):623～629.