PPH术与外剥内扎术治疗痔疮的临床应用及不良反应分析

摘要

Objective:To analyze the clinical application and adverse reaction of PPH and million-morgan hemorrhoidectomy surgery on hemorrhoids of basic-level hospital.Method:238 patients with combined hemorrhoids were selected from August 2006 to March 2010 in our hospital,which were divided into PPH group(n=136) and Milligan-Morgan group(n=102).The PPH group were used stapling hemorrhoids mucosa on circular resection treatment,the others were used milligan-morgan.The effect of treatment and the postoperative complications of the two groups were observed and compared.Result:The rate of treatment in the PPH group was 97%,and the Milligan-Morgan group was 91%,the difference was significant(P<0.05),the postoperative time of two groups had no significance(P>0.05),the activity time of postoperation of two groups was significant(P<0.05),the hospital costs and the using of analgesia pump of the two groups were significant(P<0.05).No anal stenosis,urine control and damaging to the intestinal wall occurred in both groups,postoperative bleeding,anal edema pain and postoperative recurrence of the PPH group were higher than the Milligan-Morgan group,there had statistical significance(P<0.05).Conclusion:The PPH is an effective treatment of hemoniioids in primary hospital,it is safe and reliable,and the recurrence rate is extremely low.%目的：分析基层医院使用PPH手术与外剥内扎手术治疗痔疮的效果及不良反应。方法：选择笔者所在医院2006年8月-2010年3月收治的混合痔238例，根据症状程度分为PPH组136例，外剥内扎组102例。PPH组使用吻合器痔上黏膜环形切除术治疗，外剥内扎组采取外剥内扎的手术方法。观察比较两组患者术后疗效相关指标及并发症情况。结果：PPH组治疗有效率为97%，外剥内扎组为91%(P<0.05)。两组手术时间比较差异无统计学意义(P>0.05)，而两组术后活动时间比较差异有统计学意义(P<0.05)，PPH组住院费用、镇痛泵使用居高，与外剥内扎组比较差异均有统计学意义(P<0.05)。两组均未出现肛门狭窄，大小便控制困难及损伤肠壁，而外剥内扎组术后出血、肛门水肿疼痛及术后复发均高于PPH组，两组比较差异均有统计学意义(P<0.05)。结论：基层医院使用PPH术治疗痔疮手术安全可靠，复发率极低。