中国实用外科杂志

中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (07): 600-602.

• 论著 • 上一篇    下一篇

痔上黏膜环切除术1077例回顾分析

司徒光伟1，周珞华2，辜良刚1，吕警军1   

  1. 1武汉钢铁集团公司总医院肛肠外科，湖北武汉430080；2 武汉科技大学医学院护理系外科护理教研室，湖北武汉430081
  • 出版日期:2010-07-01 发布日期:2010-06-17

  • Online:2010-07-01 Published:2010-06-17

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摘要：

目的    掌握应用吻合器痔上黏膜环切除术（PPH）手术适应证。方法    对武汉钢铁集团公司总医院肛肠外科2001年6月至2009年3月应用PPH手术方式已完成的1077例各种类型痔的病人进行随访，系统回顾分析及比较手术后各种并发症、完成辅助手术情况、再发脱垂情况。结果    （1）并发症：外痔组术后大出血2例、肛缘水肿26例、吻合口狭窄5例；内痔组术后大出血3例、肛缘水肿5例、吻合口狭窄7例；混合痔组术后大出血1例、肛缘水肿37例、吻合口狭窄11例。（2）辅助其他手术：外痔组辅助外痔切除72例、内痔套扎11例、外剥内扎23例；内痔组内痔套扎6例；混合痔组辅外痔切除术41例、内痔套扎术18例、外剥内扎13例。三组间差异有统计学意义（均P<0.05）。（3）在随访1年以上的553例病人中共复发脱垂31例，占5.6%。结论    PPH手术方式仍有一定的复发率、并发症，手术应严格掌握手术适应证。

关键词: PPH手术, 脱垂痔, 外痔切除

Abstract:

Procedure for prolapse and hemorrhoids: a retrospective analysis of 1077 cases        SITU Guang-wei*, ZHOU  Luo-hua, GU Liang-gang, et al.* Department of Anus Surgery, Affiliated General Hospital of Wuhan Steel Company, Wuhan University of Science and Technology，Wuhan 40080，China 
Corresponding  author：SITU Guang-wei, E-mail:situguangwei@126.com
Abstract    Objective    To master indication of procedure for prolapse and hemorrhoids(PPH). Methods    One thousand and seventy-seven patients performed PPH between June 2001 and March 2009 at Department of Anus Surgery, Affiliated General Hospital of Wuhan Steel Company were followed up. Postoperative complications, assistant-operation completed information and prolapse reappeared state were analyzed retrospectively. Results    （1） complications: there were 2 cases with hemorrhoea, 26 cases with edge anus dropsy and 5 cases stenosis of stoma after operation in external hemorrhoid group. There were 3 cases with hemorrhoea, 5 cases with edge anus dropsy and 7 cases stenosis of stoma after operation in internal hemorrhoid group. And there were 1 case with hemorrhoes, 37 cases with edge anus dropsy and 11 cases with stenosis of stoma after operation in mixed hemorrhoid group.  （2） other aid operation: there were 72 cases to cut cutaneous hemorrhoids, 11 cases loop ligature internal hemorrhoids, 13 out peel and inside ligature in external hemorrhoid group. There were 6 cases loop ligature internal hemorrhoids. There were 41 cases to cut cutaneous hemorrhoid, 18 cases loop ligature internal hemorrhoids, 13 cases out peel and inside ligature in mixed hemorrhoid group (all P<0.05). （3）More than 1 year of follow-up , 31  of 553 patients with recurrent prolapse, accounting for 5.6%. Conclusion    Some recurrenes and complications still existed after ppH, so indication of operation should be strict mastering.

Key words: cutaneous hemorrhoid resection, PPH, hemorrhoid of proplaps