内套外剥保留齿线术治疗环状混合痔临床观察

摘要

Objective:To observe the curative effect of internal sleeve external stripping retaining teeth line in the treatment of annular mixed hemorrhoid.Methods:60 cases of annular mixed hemorrhoid patients were randomly divided into the treatment group and the control group,30 cases in each group.The treatment group used internal sleeve external stripping retaining teeth line treatment,while the control group adopted subsection external dissection and internal ligation.The differences in clinical efficacy,wound healing time and postoperative complications were compared between groups (urinary retention,anal pain,hematochezia,anal edema and anal incontinence).The follow-up period was 6 months.The long-term effects of the two groups were observed.Results:There was no significant difference in the clinical efficacy between the treatment group and the control group (P＞ 0.05).The wound healing time of the treatment group was (20.67 ±1.95) d,and that of the control group was (24.63±2.89) d.There was significant difference between the two groups (P＜0.05).The postoperative anal pain,anal edema,bleeding,urinary retention,anal incontinence rate of the treatment group was lower than those of the control group,and the difference was statistically significant(P＜0.05).After 6 months' follow-up,the incidence of residual skin lesions and anal stenosis in the treatment group was better than that in the control group,and the difference was statistically significant (P＜0.05).There was no obvious difference in recurrent rate between the treatment group and the control group (P＜ 0.05).Conclusion:Inner sleeve external stripping retained tooth line treatment on annular mixed hemorrhoid can promote wound healing,reduce postoperative complications,and longterm curative effect is satisfactory.%目的 观察内套外剥保留齿线术治疗环状混合痔的疗效并探讨其机制.方法 60例患者按随机数字表法分为治疗组和对照组,各30例.治疗组采用内套外剥保留齿线术治疗,对照组采用分段外剥内扎术治疗,比较两组临床疗效、创面愈合时间、术后主要并发症(尿潴留、肛门疼痛、便血、肛缘水肿、肛门失禁)的差异;术后门诊随访6个月,观察两组远期疗效的差异.结果 治疗组与对照组临床疗效差别不大(P＞0.05).治疗组创面平均愈合时间(20.67±1.95)d短于对照组(24.63±2.89) d(P＜0.05).治疗组术后肛门疼痛、肛缘水肿、便血、尿潴留、肛门失禁发生率均低于对照组(均P＜ 0.05).术后6个月门诊随访,两组均无肛门失禁发生;治疗组皮赘残留、肛门狭窄发生率均低于对照组(均P＜ 0.05);治疗组复发率与对照组差别不大(P＞0.05).结论 内套外剥保留齿线术治疗环状混合痔,可促进创面愈合,降低术后并发症,远期疗效满意.