[1]李朝阳,宁玉文,沙静涛,等.分层手术与外剥内扎术治疗复杂混合痔临床疗效对比研究[J].陕西医学杂志,2023,52(2):162-165.[doi:DOI:10.3969/j.issn.1000-7377.2023.02.010]
　LI Chaoyang,NING Yuwen,SHA Jingtao,et al.Comparison of clinical effect of stratified surgery and Milligan-Morgan surgery in treatment of complex mixed hemorrhoids[J].,2023,52(2):162-165.[doi:DOI:10.3969/j.issn.1000-7377.2023.02.010]
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分层手术与外剥内扎术治疗复杂混合痔临床疗效对比研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年2期
页码:
162-165
栏目:
临床研究
出版日期:
2023-02-05

文章信息/Info

Title:
Comparison of clinical effect of stratified surgery and Milligan-Morgan surgery in treatment of complex mixed hemorrhoids
作者:
李朝阳1; 宁玉文2; 沙静涛1; 陈 娟1; 杨丽丽1; 王 昆1; 苏红波1
(1.西安市中医医院肛肠病医院,陕西 西安 710021; 2.空军军医大学,陕西 西安710032)
Author(s):
LI Chaoyang; NING Yuwen; SHA Jingtao; CHEN Juan; YANG Lili; WANG Kun; SU Hongbo
(Anorectal Hospital of Xi'an Hospital of Traditional Chinese Medicine,Xi'an 710021,China)
关键词:
复杂混合痔;  分层手术;  外剥内扎术;  疼痛;  出血;  愈合时间
Keywords:
Complex mixed hemorrhoids;  Stratified surgery;  Milligan-Morgan surgery;  Pain;  Bleeding;  Healing time
分类号:
R 657.18
DOI:
DOI:10.3969/j.issn.1000-7377.2023.02.010
文献标志码:
A
摘要:
目的:比较分层手术与外剥内扎术治疗复杂混合痔的疗效。方法:206例复杂混合痔患者,采用随机数字表法随机分为两组,治疗组采用分层手术治疗,对照组采用外剥内扎术治疗,对比治疗后临床疗效。结果:①治疗组与对照组总有效率均为99.03%,组间比较差异无统计学意义(P>0.05); ②治疗组术后疼痛、出血评分低于对照组,两组比较差异有统计学意义(均P<0.05); ③术后1～10 d,治疗组水肿发生率低于对照组,两组比较差异有统计学意义(均P<0.05); ④治疗组愈合时间短于对照组,治疗组平均住院时间低于对照组,两组比较差异均有统计学意义(均P<0.05); ⑤术前两组患者的肛管静息压、肛管平均收缩压、收缩持续时间比较均无统计学差异(均P>0.05); 术后3个月两组患者的肛管平均收缩压均较术前升高(P<0.05),组间比较无统计学差异(P>0.05); 术后3个月两组患者的肛管静息压、收缩持续时间与术前相比无统计学差异(均P>0.05),组间比较无统计学差异(均P>0.05)。结论:分层手术治疗复杂混合痔术后患者疼痛较轻、出血和水肿发生率较低,愈合时间较短,患者自身感受优于外剥内扎术。
Abstract:
Objective:To compare the efficacy of stratified surgery and Milligan-Morgan surgery in the treatment of complex mixed hemorrhoids.Methods:A total of 206 cases of complex mixed hemorrhoids patients were randomly divided into two groups.Treatment group was treated with stratified surgery,and the control group was treated with Milligan-Morgan surgery.compare The clinical efficacy after treatment was compared between two groups.Results:The total effective rate of two groups was all 99.03%,and there was no significant difference between two groups(P>0.05).The postoperative pain and bleeding scores in the treatment group were lower than those in the control group(P<0.05).1 to 10 days after operation,the incidence of edema in the treatment group was lower than that in the control group(P<0.05).The healing time and hospital stay of the treatment group were lower than those of the control group(all P<0.05).There was no significant difference in anal resting pressure,mean anal systolic pressure,and systolic duration between two groups before operation(all P>0.05).The mean anal systolic blood pressure increased in both groups at 3 months postoperatively(P<0.05),but there was no significant difference between two groups(all P>0.05).Compared with the preoperative period,there was no significant difference in anal resting pressure and systolic duration of two groups at 3 months postoperatively,and there was no significant difference between two groups(all P>0.05).Conclusion:Two methods can treat complex mixed hemorrhoids,but after stratified surgery,patients have less pain,bleeding and edema,shorter healing time,and patient's own feelings are better than those of Milligan-Morgan surgery.

参考文献/References:

[1] 陈 平,韩 宝,周 璐,等.我国居民常见肛肠疾病相关症状及分布特征[J].重庆医学,2017,46(8):1090-1092,1096.
[2] 蒙政初.吻合器痔上黏膜环切术联合缚扎术治疗重度环状混合痔疗效研究[J].陕西医学杂志,2020,49(5):561-563,567.
[3] 孙娟玲,王 燕,冷冬玲,等.混合痔治疗现状分析[J].中国现代医生,2022,60(16):152-156.
[4] 李 曼.苦参汤熏洗联合马应龙麝香痔疮膏治疗混合痔术后疗效研究[J].陕西中医,2022,43(6):744-747.
[5] 张 勇,曾宪东.我国肛肠专科学科建设与发展的现状与展望[J].结直肠肛门外科,2021,27(1):5-7.
[6] 中国中西医结合学会大肠肛门病专业委员会.中国痔病诊疗指南(2020)[J].结直肠肛门外科,2020,26(5):519-533.
[7] 刘 安,李磊磊,李雪琦,等.弹力线套扎+硬化剂注射+外剥内扎术治疗混合痔的临床疗效观察[J].结直肠肛门外科,2021,27(6):572-575.
[8] 赵 云,高 哲.中医药外治疗法治疗混合痔术后并发症临床研究概况[J].陕西中医,2020,41(2):269-272.
[9] 葛小栋,白 锦,张月姣,等.十灰散化裁治疗混合痔术后出血疗效研究[J].陕西中医,2022,43(6):748-751.
[10] 孙林梅,张永丽,郭宏珺.改良外剥内扎术配合中药熏洗治疗环状混合痔临床研究[J].陕西中医,2018,39(10):1453-1455.
[11] Chen ZQ,Liang RW,Zhang GX,et al.Application of sub-circumcision of hemorrhoid mucosa in patients with circular mixed hemorrhoids[J].Chinese Journal of Gastrointestinal Surgery,2021,24(12):1107-1110.
[12] 张亚梅,吕小平.超声刀联合吻合器痔上黏膜环切术治疗混合痔疗效研究[J].陕西医学杂志,2019,48(11):1500-1502,1518.
[13] 杨丽丽,张 磊,张 溪.自动弹力线套扎术联合外痔切除缝合术治疗环状脱垂性混合痔临床研究[J].陕西医学杂志,2018,47(2):177-179,195.
[14] Huang H,Gu YF,Li YR,et al.Modified tissue-selecting therapy stapler combined with complete anal canal epithelial preservation operation for the treatment of circumferential mixed haemorrhoids:A protocol for single-blind randomised controlled study[J].BMJ Open,2021,51(11): 82.
[15] De SH,Coremans G,Denis MA,et al.Belgian consensus guideline on the management of hemorrhoidal disease[J].Acta Gastro-enterologica Belgica,2021,84(1):58-62.
[16] Cologne KG,Linnebur M,Senagore AJ.Procedure for prolapse and hemorrhoids complication solutions:Repair of a completely closed off rectum[J].Dis Colon Rectum,2018,61(6):751.
[17] 季小健,彭 澎,刘利华,等.Ⅲ-Ⅳ度混合痔合并直肠肛管静息高压的预后相关影响因素及应用MMH术的治疗效果[J].国际外科学杂志,2022,49(2):98-102.
[18] 杨 洋,陆 雄,陈海伟,等.两种不同手术方式治疗非环状Ⅲ-Ⅳ度内痔临床研究[J].陕西医学杂志,2019,48(10):1330-1332.
[19] 郭志伟,唐迎春,翁霞惠,等.经多普勒痔动脉结扎及直肠肛管修复术治疗直肠黏膜内脱垂合并Ⅱ-Ⅲ度混合痔及对促炎因子的影响[J].中华实验外科杂志,2020,37(9):1739-1741.
[20] 李廷江,田洋平,杨勇军.改良痔外剥内扎术治疗环状混合痔的临床效果观察[J].中国普外基础与临床杂志,2020,27(8):980-984.
[21] 刘 侃,杨栓元,刘旭晨,等.PPH术治疗Ⅲ、Ⅳ度痔中长期疗效研究[J].陕西医学杂志,2019,48(2):183-185,226.

备注/Memo

备注/Memo:
基金项目:陕西省中医药传承创新暨“秦药”开发重点科学研究项目(202102ZZ016)
更新日期/Last Update: 2023-02-06