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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:

33

期数:

2016年12

页码:

1082-1084

栏目:

临床研究

出版日期:

2016-12-05

文章信息/Info

Title:

Clinical effect of stapled transanal rectal resection for treatment of severe hemorrhoids

作者:

李勇杰; 李　斌; 魏荣华

(安阳地区医院普外二科,河南　安阳　455000)

Author(s):

LI Yong-jie; LI Bin; WEI Rong-hua

(Department of NO.2 General Surgery,Anyang Regional Hospital，Anyang 455000，Henan Province，China)

关键词:

吻合器经肛门直肠切除术; 吻合器痔上黏膜环形切除术; 重度痔疮; 复发

Keywords:

stapled transanal rectal resection; procedure for prolapse and hemorrhoids; severe hemorrhoids; recurrence

分类号:

R615

DOI:

10.7683/xxyxyxb.2016.12.017

文献标志码:

A

摘要:

目的　评价吻合器经肛门直肠切除术治疗重度痔疮的临床效果，并探讨其对痔疮远期复发情况的影响。方法　选择河南省安阳地区医院收治的125例重度痔疮患者，根据手术方式将患者分为对照组58例（吻合器痔上黏膜环形切除术）和观察组67例（吻合器经肛门直肠切除术），比较2组患者术中情况、临床疗效、住院时间、住院费用及术后并发症。对2组患者随访3 a，比较其复发率。结果　观察组患者的手术时间和住院费用显著高于对照组（P<0.05）；2组患者的术中出血量和住院时间比较差异无统计学意义（P>0.05）。2组患者术后7 d出血、疼痛程度、肛门坠胀感及肛周水肿情况均优于术后1 d（P<0.05）；观察组患者在术后1 d的疼痛程度显著强于对照组（P<0.05），2组患者术后1 d出血情况、肛门坠胀感及肛周水肿评分和术后7 d的出血情况、疼痛程度、肛门坠胀感及肛周水肿评分比较差异均无统计学意义（P>0.05）。2组患者术后各发生尿潴留2例、感染1例、出血1例，2组患者术后并发症发生率比较差异无统计学意义（P>0.05）。观察组患者术后3 a复发率显著低于对照组（P<0.05）。结论　吻合器痔上黏膜环形切除术和吻合器经肛门直肠切除术均能有效治疗重度痔疮；尽管吻合器经肛门直肠切除术的手术时间及治疗费用高于吻合器痔上黏膜环形切除术，但其远期复发率较低。

Abstract:

Objective　To evaluate the clinical effect of stapled transanal rectal resection for treatment of severe hemorrhoids and explore the long-term recurrence rate.Methods　One hundred and twenty-five patients with severe hemorrhoids in Anyang Regional Hospital were selected and divided into control group(procedure for prolapse and hemorrhoids,58 patients)and observation group(stapled transanal rectal resection,67 patients)according to the operation methods.The intraoperative situation,clinical efficacy,length of stay,cost of hospitalization and postoperative complications of patients in the two groups were observed and compared.All of the patients were followed up for 3 years and the recurrence rate of patients in the two groups were compared.Results　Operation time and cost of hospitalization of patients in the observation group were significantly higher than those in the control group(P<0.05).There were no significant difference of the bleeding volume and length of stay of patients between the two groups(P>0.05).The bleeding condition,pain degree,anal bulge feeling and crissum edema of patients at 7 days after operation were better than 1 day after operation in the two groups(P<0.05).The pain degree of patients at 1 day after operation in observation group was significantly stronger than that in control group(P<0.05);there were no statistic difference of the bleeding condition,anal bulge feeling and crissum edema scores at 1 day after operation and there were no statistic difference of the bleeding condition,pain degree,anal bulge feeling and crissum edema scores at 7 days after operation of patients between the two groups（P>0.05）.There were two patients of urinary retention,one patient of infection and one patient of bleeding after operation in the two groups respectively,and there was no statistic difference of the rate of postoperative complication between the two groups（P>0.05）.The recurrence rate of the patients at 3 years after operation in observation group was significantly lower than that in control group(P<0.05).Conclusion　Both procedure for prolapse and hemorrhoids and stapled transanal rectal resection can treat severe hemorrhoids effectively.The stapled transanal rectal resection have longer operation time and higher cost,but its long-term recurrence rate is lower.

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更新日期/Last Update: 2016-12-05