改良外剥内扎加外科肛管成形术治疗环状混合痔的临床效果
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【摘要】 目的：观察和评价改良外剥内扎加外科肛管成形术治疗环状混合痔的临床疗效及安全性。方法：前瞻性将2014年8月-2015年7月本院肛肠外科收治的220例环状混合痔患者按随机序列表法分成两组，每组110例，分别行改良外剥内扎加外科肛管成形术（研究组）和传统外剥内扎术（对照组）。对比两组患者的手术情况、临床疗效和术后并发症。结果：两组患者均顺利完成手术。研究组在术后疼痛持续时间、平均住院时间、术后创面愈合时间等手术方面及术后出血、排便困难、肛缘水肿时间等并发症方面均优于对照组，差异均有统计学意义（P0.05）。术后1个月评价患者总体疗效，研究组痊愈率92.73%，对照组为81.82%，总有效率均为100%，两组患者术后痊愈率比较差异有统计学意义（P
【关键词】 环状混合痔； 外剥内扎； 外科肛管成形
Clinical Results of Improved Milligan-Morgan Hemorrhoidectomy Plus Surgical Anal Canal Reconstruction in the Treatment of Circumferential Mixed Hemorrhoids/CHEN Hua，CHEN Hong-lei，LEI Ting，et al.//Medical Innovation of China，2016，13（20）：053-056
【Abstract】 Objective：To evaluate the clinical efficacy and safety of improved Milligan-Morgan hemorrhoidectomy plus surgicalcanal reconstruction（iMMH） in treatment of circumferential mixed hemorrhoids.Method：A total of 220 patients admitted into the Department of Anorectal Surgical of our hospital，with circumferential mixed hemorrhoids from August 2014 to July 2015 were prospectively enrolled in the study and randomly divided into two groups，the study group （improved Milligan-Morgan hemorrhoidectomy plus surgicalcanal reconstruction，iMMH group） and the control group （traditional Milligan-Morgan hemorrhoidectomy，MMH group）.Surgical data， postoperative complications and efficacy were compared between the two groups.Result：As compared with the control group，patients in the study group had significantly shorter postoperative pain time，wound healing time and hospital stay time，and also had some advantages in terms of postoperative complications such as less bleeding，less defecate difficulty，short ofedge edema time（P0.05）.The total effective rate were 100% in both groups，but the cure rate in the experiment group（92.73%） was much better than that of the control group（81.82%）（P
【Key words】 Circumferential mixed hemorrhoids； Milligan-Morgan hemorrhoidectomy； Surgicalcanal reconstruction
First-author’s address：Shenzhen Bao’an District Fuyong People’s Hospital，Shenzhen 518103，China
doi：10.3969/j.issn.1674-4985.2016.20.014
传统的外剥内扎术一直是治疗痔病的标准术式[1]。但其采用的V形切口易致肛管皮肤黏膜缺失过多，每次切除痔核不能超过3个，术后水肿，切口感染的机会大，影响术后恢复及肛管功能[2]。环状混合痔是国际公认三大难治性病之一，传统的外剥内扎术切除范围偏少，对广泛病变的环状混合痔达不到治愈目的[3-5]，为此笔者采用改良外剥内扎加外科肛管成形术（iMMH）治疗环状混合痔，取得了良好的治疗效果，现报道如下。