目的 探究开环式吻合器痔上黏膜环切术（PPH）治疗痔的临床疗效。方法 回顾性分析2016年1月至2019年12月北京大学国际医院、北京同仁医院、中国航天科工集团七三一医院、安新县中医院共4所医院收治的1 798例重度痔病人，按照治疗方式不同分为PPH组（416例，吻合器痔上黏膜环切术治疗）和开环PPH组（1 382例，开环式吻合器痔上黏膜环切术治疗），比较两组手术相关指标、临床疗效、术后并发症及复发情况。结果 术后开环PPH组和PPH组治愈率比较差异无统计学意义（P>0.05）；开环PPH组手术时间、住院时间、住院费用、术中出血量与PPH组比较差异无统计学意义（P>0.05），而开环PPH组术后创面愈合时间、疼痛视觉模拟评分（VAS）低于PPH组，差异具有统计学意义（P<0.05）；开环PPH组术后尿潴留、里急后重感、肛门坠胀、肛缘水肿、肛门狭窄等并发症发生率低于PPH组，差异具有统计学意义（P<0.05）；两组复发率比较差异无统计学意义（P>0.05）。结论 开环PPH治疗重度痔与PPH疗效相当，但开环PPH术后疼痛更轻、并发症发生率低，是一种安全有效的治疗方法。
Abstract
Objective To explore the clinical effect of open-loop procedure for prolapse and hemorrhoids.Methods A retrospective analysis of 1 798 patients with severe hemorrhoids admitted to Peking University International Hospital, Beijing Tongren Hospital, 731 Aerospace Hospital, and Anxin Hospital of Traditional Chinese Medicine from January 2016 to December 2019 were divided into the PPH group (n=416, procedure for prolapse and hemorrhoids) and the open-loop PPH group (n=1 382, open-loop procedure for prolapse and hemorrhoids) by different treatment methods. The related surgical indicators and clinical efficacy, postoperative complications and recurrence were compared.Results There was no significant difference in the cure rate between the open-loop PPH group and the PPH group (P>0.05).The open-loop PPH group had no significant difference in the operation time, postoperative hospital stay, hospitalization costs, intraoperative blood loss compared with the PPH group (P>0.05), while the postoperative wound healing time and VAS score of the open-loop PPH group were lower than those of the PPH group (P<0.05). The incidence of complications such as postoperative urinary retention, tenesmus, anal swelling, anal edema, and anal stenosis in the open-loop PPH group was lower than that in the PPH group (P<0.05). There was no significant difference in the recurrence rate (P>0.05).Conclusion Open-loop PPH has the same curative effect as PPH in the treatment of severe hemorrhoids with less pain and low complication rate, which is a safe and effective treatment.
关键词
开环式痔上黏膜环切术 /
吻合器痔上黏膜环切术 /
临床疗效 /
并发症
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Key words
Open loop procedure for prolapse and hemorrhoids /
Procedure for prolapse and hemorrhoids /
Clinical efficacy /
Complications
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中图分类号：
R657.1
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