摘要
目的比较外剥内扎术(M-M)和自动痔疮套扎术(RPH)治疗环状混合痔的临床疗效及并发症发生情况。方法纳入本院2015年1月至2016年1月60例环状混合痔患者作为研究对象,随机分为A组与B组,每组各30例。A组行外剥内扎术(MM),B组行RPH。比较两组患者近远期疗效和并发症发生情况。结果 B组术后近期肛周疼痛和便血显著轻于A组(P<0.05),两组近期治愈率差异无统计学意义(P>0.05)。随访1年,A组2例失访,B组均完成随访,两组患者肛门功能均恢复正常,远期肛门功能差异无统计学意义(P>0.05),两组复发率差异无统计学意义(P>0.05)。术后近期并发症方面,B组切口感染、尿潴留、皮赘、肛缘水肿及排便困难发生率及并发症总发生率均显著低于A组(均P<0.05)。术后远期并发症方面,B组肛门狭窄、肛门坠胀、肛门溢液发生率及并发症总发生率均显著低于A组(均P<0.05)。结论与M-M相比,RPH用于环状混合痔近期疗效更优,远期肛门功能恢复好,近远期并发症相对更少,安全性高。
Objective To compare clinical efficacy and complications between Milligan Morgan（Milligan-Morgan, M-M） and automatic ligation of hemorrhoids（Ruiyun Procedure for Hemorrhoid, RPH） in the treatment of circumferential mixed hemorrhoids. Methods 60 cases of annular mixed hemorrhoids were recruited from our hospital from January 2015 to January 2016 as study subjects.They were randomly assigned to group A and group B, with 30 cases in each group. Group A underwent Milligan Morgan（M-M）, ad group B RPH. The short-and long-term effects and complications were compared between the two groups. Results Postoperative perianal pain and hematochezia was significantly lower in group B than in group A（P〈0.05）. The curative rate had no significant between-group difference（P〉0.05）. At 2-year follow up, 2 patients in group A were lost to follow-up and all patients in group B were followed-up. The anal function in both groups returned to normal. There was no significant between-group difference in long-term anal function（P〉0.05）. There was no significant between-group difference in recurrence rate（P〉0.05）. In terms of short-term complications, the incidence of incision infection, urinary retention, skin swelling, anal border edema and defecation difficulty, and overall complication rate in group B were significantly lower than those in group A（all P〈0.05）. In terms of long term complications, the incidence of anal stenosis, anus distention, anus spills and the total incidence of complications in group B were significantly lower than those in the A group（all P〈0.05）. Conclusion Compared with M-M, RPH has better short-term curative effect, better long-term anus function recovery, less long-term complications and high safety.
出处
《结直肠肛门外科》
2018年第1期45-49,共5页
Journal of Colorectal & Anal Surgery
关键词
环状混合痔
M-M
RPH
疗效
并发症
annular mixed hemorrhoids, M-M, RPH, curative effect, complication
