外剥内扎术联合PPH对老年环形混合痔的疗效

摘要

目的：：研究外剥内扎术联合吻合器痔上黏膜环切术( procedurefor prolapse and hemorrhoids,PPH)对老年环形混合痔患者的临床治疗效果。方法：选择老年环形混合痔患者160例,随机分为观察组与对照组各80例。对照组采用外剥内扎术治疗,观察组采用外剥内扎术联合PPH治疗,比较两组患者的出血、疼痛、肛缘水肿、尿潴留、排尿困难、肛门狭窄等术后并发症的发生率；对两组患者进行6个月的随访观察,比较两组的复发率,比较两组临床治疗效果。结果：观察组治疗有效率95.00%(76/80),高于对照组的81.25%(65/80)( P <0.05)；观察组出血、疼痛、肛缘水肿、肛门狭窄等并发症的发生率均低于对照组( P <0.05)；术后经过6个月的随访发现,对照组复发率(16.25%)低于观察组(6.25%)( P <0.05)。结论：外剥内扎术联合PPH对老年环形混合痔患者具有较好的治疗效果,术后并发症少且复发率低,值得临床应用推广。%Objective:To explore the curative effect of milligan-morgan hemorrhoidectomy combined with procedure for prolapse and hemor-rhoids ( PPH) on old patients with annular mixed hemorrhoids. Methods:160 cases of old patients with annular mixed hemorrhoids were selected and divided into control group and observation group, 80 cases in each group. The patients in control group accepted milligan-morgan hemorrhoid-ectomy and those in observation group adopted milligan-morgan hemorrhoidectomy combined with PPH. The rates of postoperative adverse reac-tions, including bleeding, pain, anal edema, dysuria and urinary retention and anal stenosis, were compared between the two groups. The recur-rence rate and clinical effect were evaluated and compared in the period of 6 months' follow-up. Results:The effective rate in observation group (76/80, 95. 00 %) was significantly higher than that in control group (65/80, 81. 25 %) ( P <0. 05);The incidence rates of bleeding, pain, anal edema and anal stenosis in observation group were lower than those in control group( P <0. 05);In the period of 6 months' follow-up, the recurrence rate in control group (16. 25 %) was lower than that in observation group (6. 25 %) ( P <0. 05). Conclusions:Milligan-morgan hemorrhoidectomy combined with PPH for old patients with annular mixed hemorrhoids deserves clinical popularization, with remarkable curative effects and decreased incidence of postoperative complications and recurrences.