Objective To compare the clinical effect of Doppler-guided hemorrhoid artery ligatoion with that of Milligan-Morgan hemorrhoidectomy for mixed hemorrhoids.Methods The surgical efficacy of 182 patients who had been hospitalized in our department during the period of 2009 to 2011 were retrospectively reviewed.182 patients were randomly assigned to receive Doppler-guided hemorrhoid artery ligatoion ( 92 patients,group A ),or Milligan-Morgan hemorrhoidectomy ( 92 patients,group B ).The average length of hospital stay,time of returning to work,rate of complications,and rate of hemorrhoids recurrence were compared between the two groups.Results Under the conditions of same surgical duration and intraoperative narcotic uses,the average length of hospital stay and time of returning to work were shorter in group A than in group B,with a significant difference( P＜ 0.05 ).Rate of postoperative complications including pain,bleeding and anal stenosis,and rate of hemorrhoids recurrence were lower in group A than in group B,with a significant difference ( P ＜ 0.05 ).Conclusions Doppler-guided hemorrhoid artery ligatoion,as compared with Milligan-Morgan.hemorrhoidectomy,has the advantages of shorter length of hospital stay and time of returning to work and fewer postoperative complications.The procedure meets the standards of minimally invasive surgery for hemorrhoids.%观察多普勒超生引导下痔动脉结扎术与外剥内扎痔切除术在混合痔治疗中的临床对比.方法 回顾我院肛肠科从2009至2011年收入院的182例混合痔患者的手术治疗效果,182例混合痔均为Ⅱ～Ⅲ度混合痔,随机分成两组,A组患者(n=92)行多普勒超生引导下痔动脉结扎术(Dopple-guidedhemorrhoidarteryligatoion,DG-HAL),B组患者(n=90)行传统的外剥内扎痔切除术(Milligan-MorganHemorrhoidectomy),比较两组患者术后平均住院时间、恢复工作时间、并发症及痔的复发率.结果 在手术时间无明显差别及术中麻醉药物用量基本相同的情况下,A组患者术后平均住院及恢复工作时间比B组明显缩短,差异有统计学意义(P＜ 0.05),A组患者术后的疼痛、出血、肛门便急感及肛门狭窄等并发症及痔复发率比B组明显降低,差异有统计学意义(P＜ 0.05).结论 多普勒超生引导下痔动脉结扎术与传统的外剥内扎痔切除术比较具有缩短患者住院及恢复工作时间、减少术后并发症等优点,满足了临床上痔治疗的微创外科要求.
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