PPH术与Milligan-Morgan术治疗环状痔的临床效果对照分析

doi:10．16260/j．cnki．1009 －2188．2017．02．006

中国现代手术学杂志

2017, Vol. 21

Issue (2): 104-107 DOI: 10．16260/j．cnki．1009 －2188．2017．02．006

临床论著

PPH术与Milligan-Morgan术治疗环状痔的临床效果对照分析

姚齐贤1，张天2

1．苏州市第七人民医院肛肠科，苏州215151;2．上海市普陀区中医医院肛肠科，上海200062

The Comparison of Clinical Effects of Stapled Hemorrhoidopexy Versus Milligan-Morgan Hemorrhoidectomy in Circumferential Hemorrhoids

YAO Qi-xian1，ZHANG Tian2

1．Department of Anorectal Surgery，the Seventh People＇s Hospital of Suzhou，Suzhou 215151，Jiangsu，China;2．Department of Anorectal Surgery，Tranditional Chinese Medicine Hospital of Putuo District，Shanghai 200062，China

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摘要目的探讨PPH术与Milligan-Morgan术对环状痔的临床治疗效果。方法选择2013年1月至2016年1月期间我院收治的100例环状痔患者，将患者按照随机分组的方式分成观察组及对照组，每组各50例。观察组患者采用PPH术式治疗，对照组患者采用Milligan-Morgan术式治疗。观察两组患者的疗效、并发症及随访状况。结果与治疗前相比，两组患者在问卷调查中的便血、疼痛、脱出及总分方面差异有统计学意义(P＜0．05)。观察组和对照组患者治疗后在便血、脱出及总分方面评分分别为(0．18 ±0．39)分 VS(0．05 ±0．23)分，(0．41 ±0．58 分)VS(0．16 ±0．39)分和(0．84 ±0．97)分VS(0．53 ±0．81)分，组间比较差异无统计学意义(t=0．904、0．953、0．893，P ＞0．05)，观察组疼痛症状评分为(0．24 ±0．42)分 VS(0．31 ±0．53)分，差异有统计学意义(t=6．982，P ＜0．05)。观察组和对照组患者在疼痛、下腹不适、肛门坠胀的发生率分别为8%VS 42%，14%VS 0，和24%VS 8%，差异有统计学意义(χ2=6．212、7．231、7．194，P ＜ 0．05);在水肿、尿潴留、术后复发、术后出血方面差异无统计学意义(χ2=0．948、0．942、0．924、0．894，P ＞ 0．05)。结论PPH 手术方式是一种治疗痔的新技术，治疗效果良好，但是患者的经济负担较高，需要较为严格的临床适应证，仍需临床上深入研究。

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	姚齐贤1，张天2

关键词: PPH术 Milligan-Morgan术痔

Abstract: ObjectiveTo investigate the effectiveness of patients with circumferential hemorrhoids treated with PPH and Milligan-Morgan technique．Methods100 cases with circumferential hemorrhoids from January 2013 to January 2016 were randomly assigned to procedures for prolapse and haemorrhoids(PPH)(the observation group，50 patients)and Milligan-Morgan procedures(the control group，50 patients)．The efficacy，complications and follow-up of the two groups were observed．ResultsCompared with the pre-operation，the postoperative self-reported symptom questionnaire of bleeding，pain，prolapse and total scores in both the two groups turned lower，and the difference was statistically significant(P ＜ 0．05)．The postoperative self-reported symptom questionnaire of pain in observation group was lower than the control group(t=6．982，P ＜0．05)，while the scores of bleeding，prolapse and total one had no difference between the two groups(t=0．904，0．953，0．893，P ＞0．05)．Compared with the control group，the complication rate of pain，abdominal discomfort，anal pendant expansion in the observation group and the control groups were 8%VS 42%，14%VS 0，and 24%VS 8%respectively，and the difference was statistically significant(χ2=6．212，7．231，7．194，P ＜0．05)．And the rate of edema，urinary retention，recurrence and postoperative hemorrhage had not statistically difference(χ2=0．948，0．942，0．924，0．894，P ＞0．05)．ConclusionPPH surgical treatment of hemorrhoids is a new technology with good effect and high economic cost，which requires more strict clinical indications．

Key words: PPH procedure Milligan-Morgan procedure hemorrhoids

收稿日期: 2017-02-05 修回日期: 2017-04-21 发布日期: 2018-05-25 期的出版日期: 2017-04-26

ZTFLH:

R657．18

基金资助: 上海市卫生和计划生育委员会科研项目(基金编号:20130316)

通讯作者: 姚齐贤

作者简介: 姚齐贤，男，34岁，苏州市第七人民医院肛肠科主治医师。

引用本文:

姚齐贤1，张天2. PPH术与Milligan-Morgan术治疗环状痔的临床效果对照分析[J]. 中国现代手术学杂志, 2017, 21(2): 104-107.
YAO Qi-xian. The Comparison of Clinical Effects of Stapled Hemorrhoidopexy Versus Milligan-Morgan Hemorrhoidectomy in Circumferential Hemorrhoids. Chinese Journal of Modern Operative Surgery, 2017, 21(2): 104-107.

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