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肛垫复位加分段内括约肌切断术治疗环状混合痔的临床疗效观察
张瑞芳,陈红霞,陈林,范永强,李一雄,毛红,陈朝晖
成都医学院第一附属医院中西医结合科成都 610500;四川省第二中医医院肛肠科成都 610041
摘要:
目的:观察肛垫复位加分段内括约肌切断术治疗环状混合痔的临床疗效。方法:选取环状混合痔患者100 例,随机分为对照组和治疗组,各50 例,对照组采用外剥内扎术治疗,治疗组采用肛垫复位加分段内括约肌切断术治疗,观察并记录两组患者术后7 天、1 月、3 月的直肠肛管测压情况、肛门水肿程度、肛门功能及治愈率、切口愈合时间的差异,评定其治疗效果。结果:与对照组比较,治疗组患者肛管静息压明显改善,排便更为顺畅,肛缘水肿程度较小,术后切口愈合时间较短,差异有统计学意义(P < 0.05);治疗组及对照组患者肛门功能损伤程度一致,差异无统计学意义(P > 0.05);治疗组与对照组患者治愈率差异无统计学意义(P > 0.05),说明两种手术方式的远期疗效一致。结论:肛垫复位加分段内括约肌切断术治疗环状混合痔疗效确切。
关键词:  环状混合痔  肛垫复位加分段内括约肌切断术  外剥内扎术
DOI:10.3969/j.issn.1007-6948.2020.05.019
投稿时间:2019-12-01
基金项目:四川省教育厅科研项目(17ZA0129);四川省科技支撑计划(2015sz0172)
Research on Clinical Effect of Anal Pad Reset Combined with Segmental Internal Sphincterotomy in the Treatment of Circumferential Mixed Hemorrhoid
ZHANG Rui-fang,CHEN Hong-xia,CHEN Lin
Abstract:
Objective To observe the clinical effect of anal pad reset combined with segmental internal sphincterotomy in the treatment of annular mixed hemorrhoids. Methods 100 patients with circumferential mixed hemorrhoid were selected and randomly divided into control group and treatment group. 50 cases in each group. The control group was treated with Milligan-Morgan. The treatment group was treated with anal pad reset combined with segmental internal sphincterotomy. Two groups of patients were observed and recorded the anorectal pressure measurement after 7 days, 1 month and 3 months, the degree of anal edema, the anus function,the cure rate and the differences of the healing time of incision. Meanwhile, the therapeutic effect was assessed.Results Compared with the control group, the patients in the treatment group had significantly improved anal resting pressure, more smooth defecation, less degree of anal edema, and shorter incision healing time, which were statistically significant (P < 0.05). The degree of anal function injury in the treatment group and the control group were the same, which were no statistically significant (P > 0.05). There was no significant difference in the cure rate between the treatment group and the control group (P > 0.05), which indicating that the long-term efficacy of the two surgical methods was consistent. Conclusion Anal pad reset combined with segmental internal sphincterotomy are effective in the treatment of annular mixed hemorrhoids.
Key words:  Circumferential mixed hemorrhoids  anal pad reset and segmental internal sphincterotomy  Milligan-Morgan

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