Objective To investigate the clinical value of hemorrhoids mucosa ligation combined with haemorrhoids stripping for elderly patients with moderate or severe mixed hemorrhoids. Methods From May 2011 to December 2013, in Department of Surgery, Huguosi Hospital of Traditional Chinese Medicine, 166 elderly patients with Ⅲ-Ⅳ mixed hemorrhoid were selected, and according to random number table, they were divided into group A (57 cases), group B (54 cases) and group C (55 cases). Group A was given hemorrhoids mucosa ligation combined with haemorrhoids strip-ping, group B was treated with mixed hemorrhoids traditional external dissection and internal ligation, group C was given mucosa circumcision anastomat hemorrhoid combined with haemorrhoids stripping. Operative time, efficacy, com-plications, discharge time, average cost and relapse rate after operation 12 month of three groups were recorded and compared. Results The postoperative pain and bleeding integration in three groups were compared, the difference was statistically significant (P< 0.05), and this in group A was better than those in group B and group C, the differences were statistically significant (P<0.05). The postoperative complications in the difference was statistically significant (P<0.05), this in group A (7.0%) were fewer than those in the group B (27.6%) and group C (15.8%), the differences were statistically significant (P<0.05). The hospital stay in three groups were compared, the difference was statistically significant (P<0.05), and this in group A [(7.42±2.01) d] was shorter than those in group B[(12.45±2.18) d] and group C [(10.28±2.36) d], the differences were statistically significant (P< 0.05). The average cost in three groups were com-pared, the difference was statistically significant (P< 0.05), and this in group A [(3560.06±201.37) yuan] was less than that in group C [(5634.17±276.68) yuan], the difference was statistically significant (P<0.05). The recurrence rate after op-eration 12 months in three groups were compared, the difference was statistically significant (P<0.05), and this in group A (3.5%) was better than those in group B (14.8%) and group C (10.9%), the differences were statistically significant (P< 0.05). Conclusion Hemorrhoids mucosa ligation combined with haemorrhoids stripping is a better therapy for elderly patients with moderate or severe hemorrhoids, with less injury, fewer complications, shorter hospital stay, less cost, and lower recurrence rate. It is a minimally invasive, safe, effective, and economical treatment.%目的：评价痔上黏膜套扎术结合痔核剥切技术在治疗高龄中重度混合痔患者的临床价值。方法选择2011年5月~2013年12月北京中医药大学附属护国寺中医医院外科收治的166例高龄Ⅲ~Ⅳ度混合痔患者,根据随机数字表法分为A组(57例)、B组(54例)和C组(55例)。 A组采用痔上黏膜套扎术配合痔核剥切技术,B组行传统混合痔外切内扎技术,C组行吻合器痔上黏膜环切吻合术结合痔核剥切技术。记录并比较三组患者在的手术操作时间、临床疗效、术后并发症、住院时间、住院费用和术后12个月复发率的结果。结果三组患者在术后疼痛和出血积分比较,差异有统计学意义(P<0.05),且A组优于B组和C组,差异有统计学意义(P<0.05)。三组患者的术后并发症发生率比较,差异有统计学意义(P<0.05),且A组(7.0豫)低于B组(27.6豫)和C组(15.8豫),差异有统计学意义(P<0.05)。三组患者的手术住院时间比较,差异有统计学意义(P<0.05),且A组[(7.42±2.01)d]少于B组[(12.45±2.18)d]和C组[(10.28±2.36)d],差异有统计学意义(P<0.05)。三组患者住院费用比较,差异有统计学意义(P<0.05),且A组[(3560.06±201.37)元]少于C组[(5634.17±276.68)元],差异有统计学意义(P<0.05)。三组患者的术后12个月复发率比较,差异有统计学意义(P<0.05),且A组(3.5%)少于B组(14.8%)和C组(10.9%),差异有统计学意义(P<0.05)。结论痔上黏膜套扎术结合痔核剥切技术对于高龄中、重度痔疮患者的治疗,具有损伤小、术后并发症少、住院时间短、治疗费用少、复发率低等优点,是一种微创、安全、有效、经济的方法。
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