选择性痔上黏膜切除钉合术治疗痔病的临床疗效观察
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摘要
目的观察选择性痔上黏膜切除钉合术(TST)治疗痔病的临床疗效。方法选择198例Ⅲ~Ⅳ痔病患者,随机分为2组,治疗组108例采用TST治疗,对照组90例采用传统外剥内扎治疗。观察两组患者术中出血及术后出血症状的疗效以及手术持续时间、住院时间、费用、手术副作用(肛门疼痛、肛门水肿、尿潴留)等情况,并进行统计学分析比较。结果治疗组住院时间、费用、手术时间、术中出血量、肛门狭窄疼痛、水肿发生率与对照组比较,差异均有统计学意义(P均<0.05)。结论 TST手术治疗痔病是一种操作简便、手术和住院时间短、疗效满意、并发症少、恢复较快的术式,,值得推广。
Objective To observe clinical effect of selective hemorrhoid studs of mucosal resection combined surgery(TST)for treatment of hemorrhoid diseases. Methods 198 patients with Ⅲ~Ⅳdegree hemorrhoids were evenly randomized into TST(treatment group)and Milligan-Morgan(M-M)haemorrhoidectomy(control group)respectively.Operation time,blood loss at surgery,post-operative cure rate of prolapse,and bleeding were compared. Significant postoperative anal pain,incontinence anal stenosis,and length of stay were observed. Results Operating and wound healing times and hospital stays were significantly shorter in TST group than in Milligan- Morgan group(P<0.01). And significant differences on intraoperative stretch reflex feelings,intraoperative and postoperative haemorrhage,and surgery side effects including anal ache,oedem,uroschesis and postoperative anal function between TST group and control group were observed(P<0.01). Conclusions As compared with traditional Milligan-Morgan operation. TST is a safe and effective procedure for Ⅲ and IV degree hemorrhoids so it is worth recommending.
Objective To observe clinical effect of selective hemorrhoid studs of mucosal resection combined surgery(TST)for treatment of hemorrhoid diseases. Methods 198 patients with Ⅲ~Ⅳdegree hemorrhoids were evenly randomized into TST(treatment group)and Milligan-Morgan(M-M)haemorrhoidectomy(control group)respectively.Operation time,blood loss at surgery,post-operative cure rate of prolapse,and bleeding were compared. Significant postoperative anal pain,incontinence anal stenosis,and length of stay were observed. Results Operating and wound healing times and hospital stays were significantly shorter in TST group than in Milligan- Morgan group(P<0.01). And significant differences on intraoperative stretch reflex feelings,intraoperative and postoperative haemorrhage,and surgery side effects including anal ache,oedem,uroschesis and postoperative anal function between TST group and control group were observed(P<0.01). Conclusions As compared with traditional Milligan-Morgan operation. TST is a safe and effective procedure for Ⅲ and IV degree hemorrhoids so it is worth recommending.
引文
[1]Lin HC,Ren DL,He QL,et al.Partial stapled hemorrhoidopexy versus circular stapled hemorrhoidopexy for gradeⅢ-Ⅳprolapsing hemorrhoids:a two-year prospective controlled study[J].Tech Coloproctol,2012,16(5):337-343.
[2]余智涛,温圣荣,王悦辉.TST与PPH治疗重度内痔临床疗效对照研究[J].结直肠肛门外科,2013,19(3):1001-9448.
[3]中华医学会外科学分会结直肠肛门外科学组,中华中医药学会肛肠病专业委员会,中国中西医结合学会结直肠肛门病专业委员会.痔临床诊治指南(2006版)[J].中华胃肠外科杂志,2006,9(9):461-463.
[4]王永强,李丽梅.选择性痔上黏膜切除钉合术治疗脱垂性痔病的临床研究[J].实用临床医药杂志,2012,16(17):84-86.
[5]林宏城,任东林,谢尚奎.选择性痔上黏膜切除钉合术与痔上黏膜环切钉合术的对比研究[J].广东医学,2011,32(11):1457-1460.
[6]冯涛,裴一爽,杨勇,等.开环式微创吻合术(TST)治疗混合痔77例临床分析[J].现代药物应用,2012,14(6):53-54.
[7]成川江,王启,吴韬.TST手术治疗痔病的临床疗效观察[J].结直肠肛门外科,2010,19(4):240-242.
[8]姚劲斌,罗湛滨.选择性痔上黏膜切除钉合术治疗环状混合痔[J].广东医学,2012,33(17):2571.
[9]杨权光.吻合器痔上黏膜钉合术治疗环状脱垂性痔的临床效果观察[J].中国医学创新,2012,9(10):40-41.
[10]马翔,陈小岚,盛光.开环式微创肛肠吻合器痔切闭术治疗脱垂性痔病的临床研究[J].现代临床外科,2011,11(6):436-437.
[11]万廷军.PPH在重度痔疮患者中的疗效分析[J].中国医学创新,2013,10(5):58-59.
[2]余智涛,温圣荣,王悦辉.TST与PPH治疗重度内痔临床疗效对照研究[J].结直肠肛门外科,2013,19(3):1001-9448.
[3]中华医学会外科学分会结直肠肛门外科学组,中华中医药学会肛肠病专业委员会,中国中西医结合学会结直肠肛门病专业委员会.痔临床诊治指南(2006版)[J].中华胃肠外科杂志,2006,9(9):461-463.
[4]王永强,李丽梅.选择性痔上黏膜切除钉合术治疗脱垂性痔病的临床研究[J].实用临床医药杂志,2012,16(17):84-86.
[5]林宏城,任东林,谢尚奎.选择性痔上黏膜切除钉合术与痔上黏膜环切钉合术的对比研究[J].广东医学,2011,32(11):1457-1460.
[6]冯涛,裴一爽,杨勇,等.开环式微创吻合术(TST)治疗混合痔77例临床分析[J].现代药物应用,2012,14(6):53-54.
[7]成川江,王启,吴韬.TST手术治疗痔病的临床疗效观察[J].结直肠肛门外科,2010,19(4):240-242.
[8]姚劲斌,罗湛滨.选择性痔上黏膜切除钉合术治疗环状混合痔[J].广东医学,2012,33(17):2571.
[9]杨权光.吻合器痔上黏膜钉合术治疗环状脱垂性痔的临床效果观察[J].中国医学创新,2012,9(10):40-41.
[10]马翔,陈小岚,盛光.开环式微创肛肠吻合器痔切闭术治疗脱垂性痔病的临床研究[J].现代临床外科,2011,11(6):436-437.
[11]万廷军.PPH在重度痔疮患者中的疗效分析[J].中国医学创新,2013,10(5):58-59.