目的 探讨痔上黏膜环型切除术(procedure for prolapse and hemorrhoids,PPH)与外剥内扎术在重度痔疮患者中应用效果.方法 方便选取2022年5月—2024年4月徐州矿务集团总医院收治的98例重度痔疮患者为研究对象,根据不同手术方法分为对照组、研究组,各49例.对照组接受外剥内扎术治疗,研究组接受PPH治疗,对比两组临床指标、疼痛程度、肛肠动力学与术后并发症发生情况.结果 研究组手术时间、创面愈合时间、住院时间均短于对照组,术中出血量低于对照组,差异有统计学意义(P均<0.05).术后5 d,两组疼痛程度评分均低于术前,研究组低于对照组,差异均有统计学意义(P均<0.05).术后4周,研究组直肠最大耐受容量、肛管最大收缩压与术前对比,差异均无统计学意义(P均>0.05);对照组直肠最大耐受容量、肛管最大收缩压均低于术前,研究组高于对照组,差异均有统计学意义(P均<0.05).研究组并发症发生率2.04%(1/49)低于对照组的16.33%(8/49),差异有统计学意义(χ2=4.404;P<0.05).结论 相较于外剥内扎术,PPH治疗重度痔疮具有创伤小、康复快、出血量少等优势,且有效缓解了术后疼痛,促进肛肠动力恢复,降低并发症风险.
Analysis of Application Effect of Procedure for Prolapse and Hemorrhoids and Milligan-Morgan Hemorrhoidectomy in Patients with Severe Hemor-rhoids
Objective To investigate the application effect of procedure for prolapse and hemorrhoids(PPH)and Milligan-Morgan hemorrhoidectomy in patients with severe hemorrhoids.Methods A total of 98 patients with severe hemorrhoids admitted to Xuzhou Mining Group General Hospital from May 2022 to April 2024 were conveniently se-lected as the research objects.According to different surgical methods,they were divided into control group and study group,with 49 cases in each group.The control group was treated with Milligan-Morgan hemorrhoidectomy,and the study group was treated with PPH.The clinical indexes,pain degree,anorectal dynamics and postoperative complica-tions were compared between the two groups.Results The operation time,wound healing time and hospitalization time of the study group were shorter than those of the control group,and the intraoperative blood loss was lower than that of the control group,the differences were statistically significant(all P<0.05).At 5 d after operation,the scores of pain degree in the two groups were lower than those before operation,and that in the study group were lower than the con-trol group,the differences were statistically significant(all P<0.05).There was no significant difference in the maxi-mum tolerable volume and the maximum systolic pressure between the study group before and a weeks after operation(P>0.05).The maximum tolerance volume and the maximum systolic pressure in the control group 4 weeks after opera-tion were lower than those before operation,and those in the study group were higher than those in the control group,the differences were statistically significant(all P<0.05).The incidence of complications in the study group was 2.04%(1/49)lower than 16.33%(8/49)in the control group,and the difference was statistically significant(χ2=4.404;P<0.05).Conclusion Compared with Milligan-Morgan hemorrhoidectomy,PPH has the advantages of less trauma,faster recovery and less bleeding in the treatment of severe hemorrhoids.It can effectively relieved the postoperative pain,promote the recovery of anorectal motility and reduce the risk of complications.
Procedure for prolapse and hemorrhoidsMilligan-Morgan hemorrhoidectomySevere hemorrhoids
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