Clinical Effect on Procedure for Prolapse and Hemorrhoids Combined with Sclerotherapy of Lauromacrogol Injection for Severe Hemorrhoids: 86 Cases Reports
LEI Qingjun1, ZHANG Yiqiang1, WANG Yi1, HE Xiangdong2
1.Department of General Surgery， the First People's Hospital of Taicang，Taicang 215400, Jiangsu, China; 2.Department of Colorectal Surgery，Traditional Chinese Hospital of Xi'an，Xi'an 710021, Shaanxi, China
摘要 目的探讨吻合器痔上黏膜环切订合术(procedure for prolapse and hemorrhoids, PPH术)联合聚桂醇硬化剂注射治疗重度痔的临床疗效。方法将170例重度痔(Ⅲ、Ⅳ期)患者按入院顺序随机分为两组：治疗组86例，采用PPH术加聚桂醇硬化剂注射治疗；对照组84例，采用传统外剥内扎术加聚桂醇硬化剂注射治疗。比较两组患者手术情况、临床治疗效果及术后并发症。结果治疗组平均手术时间和平均住院时间分别为(23.25±3.41）min和(5.20±0.94）d， 对照组分别为(60.11±4.85）min和(12.57±1.52）d，组间比较均有统计学差异，治疗组均明显优于对照组（P<0.05）。两组总体疗效评价，治疗组内痔脱垂及出血症状有效率分别为95.3%和96.5%，高于对照组的85.7%和88.1%，差异有统计学意义(P<0.05)。治疗组术后疼痛、肛缘水肿、排尿困难等并发症均少于对照组(P<0.05)，两组术后排便异常情况比较差异无统计学意义(P>0.05)。术后20 d及6个月后随访，两组无一例发生肛门狭窄。结论PPH术加聚桂醇硬化剂注射治疗重度痔操作简便，对肛门功能损伤小，疗效确切，值得临床推广。
Abstract: ObjectiveTo explore the clinical efficacy of procedure for prolapse and hemorrhoids (PPH) combined with sclerotherapy of lauromacrogol injection for treatment of severe hemorrhoids.MethodsA total of 170 cases with severe hemorrhoids (Ⅲ or Ⅳ stage) were randomized into two groups: The treatment group (n=86) were treated by PPH combined with sclerotherapy lauromacrogol injection， and the control group (n=84) were performed the MilliganMorgan haemorrhoidectomy combined with sclerotherapy of lauromacrogol injection. The perioperative outcomes, clinical effect and postoperative complication were compared between two groups.ResultsThe average operative duration and hospital stays was (23.25±3.41)min and (5.20±0.94)d respectively in the treatment group, and was (60.11±4.85)min and (12.57±1.52)d respectively in the control group. There was statistical difference in operative duration and hospital stays between two groups, the treatment group was better （P<0.05）. The total result revealed the effective rate of the treatment group was 95.3% and 96.5% in prolapse symptom and hemorrhage symptom, both were higher than 85.7% and 88.1% of the control group (P<0.05). The postoperative complication of anal pain, analedge edema and dysuria was less in the treatment group than those in the control group (P<0.05), but there was no statistical difference in abnormal defecation between two groups (P>0.05). No anal stenosis was found during followup in both groups.ConclusionThe treatment of PPH combined with sclerotherapy of lauromacrogol injection is an effective therapy for severe hemorrhoids with less damage of the anal function, reliable effect and simple operating.
雷庆军1，张毅强1，王益1，贺向东2. 吻合器痔上黏膜环切订合术联合聚桂醇硬化剂注射治疗重度痔：86例疗效分析[J]. 中国现代手术学杂志, 2017, 21(1): 22-26.
LEI Qingjun1, ZHANG Yiqiang1, WANG Yi1, HE Xiangdong2. Clinical Effect on Procedure for Prolapse and Hemorrhoids Combined with Sclerotherapy of Lauromacrogol Injection for Severe Hemorrhoids: 86 Cases Reports. Chinese Journal of Modern Operative Surgery, 2017, 21(1): 22-26.
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2017, Vol. 21 
