外痔切剥辅助吻合器痔上黏膜环切术治疗混合痔的临床研究

为观察和评价外痔切剥辅助吻合器痔上黏膜环切术（PPH）治疗混合痔的临床疗效，将195例混合痔患者分为A组（101例）和B组（94例），分别采用外痔切剥辅助PPH和外剥内扎术治疗，并在术后1d、术后3d、术后1周及术后3个月对便血、肛门疼痛、肛门或会阴坠胀、肛门不适、肛缘肿物突出、肛门潮湿、肛门瘙痒根据疗效评分标准进行评价。结果显示，A组手术时间、创口愈合时间、术后恢复工作时间明显短于B组（P〈0．05），A组在术后1d、术后3d和术后1周便血、肛门疼痛、肛门或会阴坠胀、肛门不适、肛缘肿物突出、肛门潮湿和肛门瘙痒情况均少于B组（P〈0．05）；术后3个月肛缘肿物突出A组明显少于B组（P〈O．05）。结果表明，外痔切剥辅助PPH治疗混合痔具有对肛门功能损伤小，疼痛轻，术后并发症少，恢复快，术后复发率低，且手术方法简单，易于掌握和推广。

Clinical Study on the Therapeutic Results of the Combined Procedure of Resection and Dissection of the Exter- nal Hemorrhoids Associated with PPH in the Treatment of Mixed Hemorrhoids

The objective of this study was to observe and evaluate the therapeutic effect of the combined procedure of resection＆dissection of external hemorrhoids associated with PPH. One hundred and ninety five patients with mixed hemorrhoids（MH） were divided into A and B groups. Patients in A group（ n 101） underwent resection and dissection of the external hemorrhoids plus PPH （RDEH-PPH） and patients in B group（ n=94） external dissection and internal ligation. The postoperative status were recorded and evaluated. As results, the operation time, wound healing time and postoperative recovery working time were notable shorter in group A than in group B（ P〈0.05）, the indexes of hematochezia,anal pain, tenesmus sensation of anus or perineum anal uncomfortable,anal projection,anal moisture and anal pruritus recorded at the postoperative lst,3rd and 7th day were better in group A than in group B（ P〈0.05） ;in the postop- erative 3 monthes perianal projection was also notable smaller in group A than in group B（ P d0.05）. It is concluded that RDEH-PPH can ensure mini-injury to anal function, mild pain, less complication, quicker recovery,lower recurrence rate in addition to its sirnnler manipulation easy mastery and popularization.