外切与外剥内扎硬注术治疗环状嵌顿痔疗效比较

摘要

Objective To compare the efficacy and complications of the two therapeutics to the circular in⁃carcerated hemorrhoids, by external excision and internal ligation and sclerotherapy, and by Milligan-Morgan op⁃eration and sclerosing agent injection. Methods Retrospective analysis on the clinical data of 156 circular in⁃carcerated hemorrhoids patients was done, 78 cases received external excision and internal ligation and sclero⁃therapy as group A, and 78 cases received Milligan-Morgan operation and sclerosing agent injection as group B. The changes of symptom scores, wound healing time and incidence of complications of both groups before and af⁃ter treatment were observed and compared. Results One month after treatment, the symptom scores of the ob⁃servation group and control group were (0.07 ± 0.32) and (0.06 ± 0.34) (P>0.05). The wound healing time of the observation group was significantly shorter than that of the control group (15.61 ± 2.01 vs 18.58 ± 2.81, P<0.05). The differences of the incidence of complications, including hemafecia in 1 week, perianal epicanthus, co⁃pracrasia and anorectal stenosis, between the two groups were not statistically significant (P>0.05). In the obser⁃vation group, the incidence rates of anal pain, dysuresia and edema of anal margin were 7.69%, 3.85% and 3.85% (P<0.05). Conclusion The combined treatment of external excision and internal ligation and sclero⁃therapy was effective for circular incarcerated hemorrhoids. It can effectively shorten the wound healing time and reduce the incidence of anal pain and dysuresia..%目的：对比外切与外剥内扎硬注术治疗环状嵌顿痔的疗效和并发症。方法：回顾性分析156例环状嵌顿痔患者的临床资料，78例接受外切内扎硬注术为A组，78例接受外剥内扎硬注术为B组，对比两组治疗前后的症状评分变化情况，对比两组术口愈合时间和并发症发生情况。结果：手术治疗后1个月，A组症状评分（0.07±0.32）分，B组（0.06±0.34）分（P＞0.05）；A组术口愈合时间（15.61±2.01）d，B组（18.58±2.81）d（P＜0.05）；两组术后1周便血、肛缘赘皮、肛门失禁、肛管狭窄发生率的对比，差异没有统计学意义（P＞0.05）。A组术后1周肛门疼痛发生率7.69%，排尿困难发生率3.85%，肛缘水肿发生率3.85%，均显著低于B组（P＜0.05）。结论：外切内扎硬注术治疗环状嵌顿痔具有良好的临床疗效，可有效缩短术口愈合时间，减少肛门疼痛、排尿困难等术后并发症的发生率。