摘要
目的 总结急性痔病急诊激光手术的疗效。方法 1996年 1月以来 ,在门诊行急诊激光手术治疗急性痔病 6 2 0例。用组织钳将要切除的痔块提起 ,在其根部齿线上方先作“8”字贯穿缝合结扎 ,再作单纯缝扎 ,用弯止血钳在基底扎线上方挟住痔块 ,用功率 30～ 40W的CO2 激光将痔块迅速切除。对脱出范围不超过 1/ 2肛周的 1～ 2个嵌顿痔可一次切除 ;对脱出范围超过 1/ 2肛周者可根据脱出痔块的大小决定切除数量 ,一般一次切除不超过 4个 ,可选择性切除 2～ 3个大痔块后 ,再将Nd∶YAG激光光纤刺入余下的痔块内以 2 0～ 30W功率进行汽化、凝固。结果 术后当日疼痛即可减轻 ,术后 7天疼痛肿胀基本消失。 5 12例 (82 6 % )在术后 30天内痊愈 ,10 8例 (17 4% )在 30～ 45天痊愈。 6例并发严重出血 ,经缝扎出血点而控制。发生尿潴留行导尿者 18例。发生肛门狭窄 1例 ,经手术治愈。结论 急诊激光手术可迅速解除急性痔病病人痛苦 ,手术简便 ,出血少 ,并发症少 ,疗程较短 ,不需住院 ,是一种比较好的治疗方法。
Objective To investigate the effectiveness of emergency laser operation(ELO) for acute hemorrhoidal disease. Methods 620 patients with acute hemorrhoidal disease have been treated in the outpatient department since January 1996. Pull up the mass of hemorrhoids with tissue forceps. Transfixing suture ligation at the base of the mass by “figure of eight” and then a single suture ligation was added. Clamp the bottom of the mass with forceps and resect the mass immediately using CO 2 laser with power density between 30 W and 40 W. To excise completely one or two of the incarcerated mass in which the prolape range is less than half of the anus. The mass in which pro lape range exceeds half of the anus, the number of hemorrhoidal lumps to be excised depends on the size of the mass. As a rule no more than 4 lumps should be excised at one time. After removing two or three lumps insert the sharp fibre of Nd∶YAG laser probe into the remaining mass for evaporation and coagulation. Results Pain weakened immediately and swelling disappeared within a week postoperationally. 521 cases (82 6%) were cured within a month and 108 cases (17 4%) were cured within 30 to 45 days. Serious hemorrhage occurred in 6 cases which was successfully controlled by ligation of the bleeding sites. Urine catheterization due to urinal retention was performed in 18 cases. Stricture of anus occurred in one case and was treated by surgical excision. Conclusions Emergency laser operation can alleviate the suffering of the patients. Simple procedure, less bleeding and complication, and short duration are the merits of this method for treatment of acute hemorrhoidal disease.
出处
《中国激光医学杂志》
CAS
CSCD
2000年第2期93-95,共3页
Chinese Journal of Laser Medicine & Surgery
关键词
痔
激光手术
治疗
Hemorrhoids
Laser surgery
