吻合器痔上黏膜环切钉合术双荷包缝合法治疗重度痔的临床对比研究
摘要
目的:观察和评价吻合器痔上黏膜环切钉合术(PPH)双荷包缝合法治疗重度痔的临床疗效。
方法:将80例Ⅲ-Ⅳ期重度痔患者随机分成实验组和对照组,其中实验组(40例)采用PPH双荷包缝合法;对照组(40例)采用PPH单荷包缝合法。观察两组病例在切除黏膜的均匀程度、宽度、控制吻合口的位置、痔核回缩、术后并发症及近期疗效的情况,应用医学统计学软件SPSS13.0对结果进行统计学分析,P＜0.05表示差异有显著性意义。
结果:实验组在切除黏膜环的均匀程度、宽度、控制吻合口的位置、痔核回缩等方面优于对照组(P＜0.05),在手术时间、术中出血方面对照组优于治疗组(P＜0.05),在术后出血、疼痛、尿潴留、住院时间以及近期疗效方面两者无显著性差异(P＞0.05)。
结论:实验组在切除黏膜环的均匀程度、切除黏膜环的宽度、控制吻合口的位置,痔核回缩等方面优于对照组。
Objective:To observe and evaluate the clinical efficacy of the therapeutics toⅢ-Ⅳstages of hemorrhoid with PPH by means of double pouches.
Methods:A randomized study was made in 80 patients,the study group(40cases) received the treatment of PPH with double pouches,the control group(40cases) received the single pouch of PPH.Study the uniformity coefficient and the breadth of the mucous membrane had be cut off by anastomat,controlling position of anastomotic stoma,replacement of the prolapsed hemorrhoid,therapeutic effect and complication after surgical operation and the short term therapeutic effect of the two groups.
Results:The uniformity coefficient and the breadth of the mucous membrane be cut off,controlling position of anastomotic stoma and replacement of the prolapsed hemorrhoid of the study group are much better than control group,had significant difference(P＜0.05),on the contrary,the operative time and hemorrhage during the operative process are worse than control group(P＜0.05).Hemorrhage after the operation、sensation of pain in the anus、urine retention、heal time of the raw surface and the short term therapeutic effect of the two groups had no significant difference(P＞0.05).
Conclusion:For severe hemorrhoid,the uniformity coefficient and the breadth of the mucous membrane had be cut off,controlling position of anastomotic stoma and the replacement of the prolapsed hemorrhoid of the study group are more stable and utility than the control group.
方法:将80例Ⅲ-Ⅳ期重度痔患者随机分成实验组和对照组,其中实验组(40例)采用PPH双荷包缝合法;对照组(40例)采用PPH单荷包缝合法。观察两组病例在切除黏膜的均匀程度、宽度、控制吻合口的位置、痔核回缩、术后并发症及近期疗效的情况,应用医学统计学软件SPSS13.0对结果进行统计学分析,P＜0.05表示差异有显著性意义。
结果:实验组在切除黏膜环的均匀程度、宽度、控制吻合口的位置、痔核回缩等方面优于对照组(P＜0.05),在手术时间、术中出血方面对照组优于治疗组(P＜0.05),在术后出血、疼痛、尿潴留、住院时间以及近期疗效方面两者无显著性差异(P＞0.05)。
结论:实验组在切除黏膜环的均匀程度、切除黏膜环的宽度、控制吻合口的位置,痔核回缩等方面优于对照组。
Objective:To observe and evaluate the clinical efficacy of the therapeutics toⅢ-Ⅳstages of hemorrhoid with PPH by means of double pouches.
Methods:A randomized study was made in 80 patients,the study group(40cases) received the treatment of PPH with double pouches,the control group(40cases) received the single pouch of PPH.Study the uniformity coefficient and the breadth of the mucous membrane had be cut off by anastomat,controlling position of anastomotic stoma,replacement of the prolapsed hemorrhoid,therapeutic effect and complication after surgical operation and the short term therapeutic effect of the two groups.
Results:The uniformity coefficient and the breadth of the mucous membrane be cut off,controlling position of anastomotic stoma and replacement of the prolapsed hemorrhoid of the study group are much better than control group,had significant difference(P＜0.05),on the contrary,the operative time and hemorrhage during the operative process are worse than control group(P＜0.05).Hemorrhage after the operation、sensation of pain in the anus、urine retention、heal time of the raw surface and the short term therapeutic effect of the two groups had no significant difference(P＞0.05).
Conclusion:For severe hemorrhoid,the uniformity coefficient and the breadth of the mucous membrane had be cut off,controlling position of anastomotic stoma and the replacement of the prolapsed hemorrhoid of the study group are more stable and utility than the control group.
引文
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[9]张吕泉.痔病的中医药治疗进展.中医药临床杂志,2004年12月第16卷第6期
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[22]傅传刚,张卫,王汉涛,等.吻合器环形痔切除术.中国实用外科杂志,2001,21:653-655
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