开环式微创痔吻合术与吻合器痔上黏膜环切术治疗痔病的临床效果比较
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摘要
目的探讨开环式微创痔吻合术(TST)和吻合器痔上黏膜环切术(PPH)治疗痔病的临床价值。方法选取我院2013年1月~2014年7月收治入院的痔病患者100例作为研究对象,按随机数字表法将其分为治疗组和对照组,治疗组行TST,对照组行PPH,比较两组的疗效及不良反应。结果治疗组患者平均手术时间、平均住院时间、创面平均愈合时间均明显短于对照组,两组比较差异有统计学意义(P<0.05)。治疗组患者术后6、12、24 h疼痛感评分显著低于对照组,差异有统计学意义(P<0.05)。术后1个月进行随访,治疗组未发生肛门狭窄和肛门失禁;对照组未发生肛门失禁,2例发生肛门狭窄,肛门指诊示指可通过,出现大便变细,但粪便排出通畅。术后3个月进行随访,两组均无病例复发。结论 TST治疗痔病的疗效优于PPH,值得临床推广应用。
Objective To explore the clinical value of tissue-selecting therapy stapler(TST) and procedure for prolapse and hemorrhoids with stapler(PPH) on treating hemorrhoids. Methods From January 2013 to July 2014,100 patients with hemorrhoids admitted into our hospital were selected and divided into treatment group and control group by random number table.In the treatment group,TST was used,while in the control group,PPH was adopted.The therapeutic effect and adverse reaction were compared. Results In the treatment group,the average operative time,hospital stay at average,and mean wound healing time was greatly shorter than that in the control group respectively,with statistical differences(P <0.05).Pain sensation 6,12,and 24 h after surgery in the treatment group was lower than that in the control group respectively,which displayed a statistical difference(P <0.05).Follow up visits were carried out one month after surgery,there was no stricture of anus or anal incontinence occurred in the treatment group.In the control group,no anal incontinence was found,but two cases were presented with stricture of anus.Index finger could pass through in digital rectal examination.The shape of stool became fine,and could be defecated smoothly.After 3 months follow up visits,no case was recurred between two groups. Conclusion Effect of TST on treating hemorrhoids is superior to that by PPH,which is worthy of clinical application and promotion.
Objective To explore the clinical value of tissue-selecting therapy stapler(TST) and procedure for prolapse and hemorrhoids with stapler(PPH) on treating hemorrhoids. Methods From January 2013 to July 2014,100 patients with hemorrhoids admitted into our hospital were selected and divided into treatment group and control group by random number table.In the treatment group,TST was used,while in the control group,PPH was adopted.The therapeutic effect and adverse reaction were compared. Results In the treatment group,the average operative time,hospital stay at average,and mean wound healing time was greatly shorter than that in the control group respectively,with statistical differences(P <0.05).Pain sensation 6,12,and 24 h after surgery in the treatment group was lower than that in the control group respectively,which displayed a statistical difference(P <0.05).Follow up visits were carried out one month after surgery,there was no stricture of anus or anal incontinence occurred in the treatment group.In the control group,no anal incontinence was found,but two cases were presented with stricture of anus.Index finger could pass through in digital rectal examination.The shape of stool became fine,and could be defecated smoothly.After 3 months follow up visits,no case was recurred between two groups. Conclusion Effect of TST on treating hemorrhoids is superior to that by PPH,which is worthy of clinical application and promotion.
引文
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[4]廖秀军,孟强,杨关根,等.吻合器痔上黏膜环切钉合术加外痔切除术治疗混合痔的疗效分析[J].中华胃肠外科杂志,2008,11(6):525-528.
[5]廖颖婴,魏志军,张悦,等.TST术与Milligan-Morgan术治疗混合痔疗效对比观察[J].中医外治杂志,2012,6(21):10-11.
[6]王彦芳,于洪顺.改良瘢痕切开术治疗PPH术后吻合口狭窄[J].中外医学研究,2012,10(31):125-126.
[7]芦婷婷,张光哲.选择性痔上黏膜吻合器在直肠良性肿瘤治疗上的应用[J].中华普外科手术学杂志(电子版),2012,6(2):52-53.
[8]王业皇,章阳,严进,等.开环式微创痔吻合器治疗痔病的临床效果[J].江苏医药,2010,36(11):1249-1252.
[9]肖黎波,王剑鸣,陈遇源.喷他佐辛复合罗哌卡因对痔疮手术术后镇痛的效果观察[J].国际医药卫生导报,2013,19(14):2144-2146.
[10]孙涛,左富义,崔伟.地奥司明治疗混合痔术后肛周创面水肿及疼痛效果观察[J].人民军医,2011,54(6):491-495.
[11]王艳,王业皇.开环式痔微创吻合术治疗脱垂性痔病术后排便通畅程度的临床研究[J].中医学报,2012,27(5):551-553.
[12]吴金艳,王金海,叶丹,等.不同处理方法对痔术后创面疼痛及愈合的效果观察[J].中华护理杂志,2012,47(9):781-783.
[2]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].岭南现代临床外科,2011,11(6):436-438.
[3]成川江,王启,吴韬.TST手术治疗痔病的临床观察[J].结直肠肛门外科,2010,16(4):240-243.
[4]廖秀军,孟强,杨关根,等.吻合器痔上黏膜环切钉合术加外痔切除术治疗混合痔的疗效分析[J].中华胃肠外科杂志,2008,11(6):525-528.
[5]廖颖婴,魏志军,张悦,等.TST术与Milligan-Morgan术治疗混合痔疗效对比观察[J].中医外治杂志,2012,6(21):10-11.
[6]王彦芳,于洪顺.改良瘢痕切开术治疗PPH术后吻合口狭窄[J].中外医学研究,2012,10(31):125-126.
[7]芦婷婷,张光哲.选择性痔上黏膜吻合器在直肠良性肿瘤治疗上的应用[J].中华普外科手术学杂志(电子版),2012,6(2):52-53.
[8]王业皇,章阳,严进,等.开环式微创痔吻合器治疗痔病的临床效果[J].江苏医药,2010,36(11):1249-1252.
[9]肖黎波,王剑鸣,陈遇源.喷他佐辛复合罗哌卡因对痔疮手术术后镇痛的效果观察[J].国际医药卫生导报,2013,19(14):2144-2146.
[10]孙涛,左富义,崔伟.地奥司明治疗混合痔术后肛周创面水肿及疼痛效果观察[J].人民军医,2011,54(6):491-495.
[11]王艳,王业皇.开环式痔微创吻合术治疗脱垂性痔病术后排便通畅程度的临床研究[J].中医学报,2012,27(5):551-553.
[12]吴金艳,王金海,叶丹,等.不同处理方法对痔术后创面疼痛及愈合的效果观察[J].中华护理杂志,2012,47(9):781-783.