摘要:
目的 对比内套外剥齿线保留术与内扎外剥术治疗Ⅱ~Ⅲ度混合痔的疗效,对内套外剥齿线保留术进行临床疗效及安全性评价.方法 将60例符合纳入标准的Ⅱ~Ⅲ度混合痔患者随机分为治疗组和对照组,每组30例.治疗组采用内套外剥齿线保留术,对照组采用经典的内扎外剥术.观察记录2组患者术中切口个数,术后第1天、第3天、第7天和第14天的疼痛、出血、水肿、渗出、排便困难等数据,进行统计学分析.结果 治疗组和对照组在切口个数,术后第1天、第3天、第7天和第14天的水肿、渗出等情况比较无统计学意义.2组患者在第3天、第7天的疼痛、排便困难情况比较存在统计学意义(P<0.05),治疗组优于对照组.术后第1天、14天的疼痛、排便困难情况2组差异无统计学意义;2组患者在第7天的出血情况存在统计学意义(P<0.05),治疗组优于对照组;术后第1天、第3天、第14天的出血情况2组比较差异无统计学意义.结论 内套外剥齿线保留术相对于传统内扎外剥术在治疗Ⅱ~Ⅲ度混合痔的总体疗效方面无统计学意义,但在术后第7天出血,术后第3天、第7天疼痛、排便困难等方面优势明显,同时具有手术创伤小,术后并发症少等特点.%Objective To evaluate the clinical efficacy and safety of internal ligation and external dissection dentate line-sparing procedure in treating stage Ⅱ - Ⅲ mixed hemorrhoids by comparing the effects of both internal rubber band ringing and external dissection dentate line-sparing procedure and Milligan-Morgan procedure. Methods 60 cases with stage Ⅱ - Ⅲ mixed hemorrhoids were randomly divided into treatment group and control group, with 30 cases in each group. The treatment group was treated with internal rubber band ringing and external dissection dentate line-sparing procedure, and the control group was treated with conventional Milligan-Morgan procedure. Hemorrhage in operation, number of incision, edema and bowel movement problems on 1st, 3rd, 7th and 14th day, recorded and analyzed statistically. Results The difference in number of incision, postoperative pain and bowel movement problem on 3rd and 7th day between two groups was statistically significant (P<0.05). There was no statistical significance between treatment group and treatment group in terms of the postoperative edema and exudation on 1st, 3rd, 7th and 14th day. When it comes to postoperative bleeding on day 7, cases in treatment group were lesser (P<0.05 ), while there was no statistical significance in terms of difference in postoperative bleeding condition on day 1, day 3 and day 14. Conclusions Internal rubber band ringing and external dissection dentate line-sparing procedure and conventional Milligan-Morgan procedure are similar in general clinical efficacy, while the former shows much more advantages in postoperative bleeding on day 7, pain and bowel movement on day 3 and day 7 after the operation. And internal rubber band ringing and external dissection dentate line-sparing procedure is safe and effective in treating stage Ⅱ - Ⅲ mixed hemorrhoids. In addition, less pain and economic burden for patients makes it popular and worth of extensive application.