目的 对痔切除吻合器痔上黏膜环切术(PPH)与传统手术在治疗混合痔环状脱垂或内痔环状脱垂的疗效进行比较。方法 回顾性分析2002年1月至2004年9月西苑医院收治的832例经内镜确诊为内痔及混合痔患者的临床资料。结果 PPH组: 混合痔247例,治愈228例(92.3%),显效19例(7.7%); 内痔168例均治愈(100%); 术后发生大出血2例(0.5%),住院时间3.1~6.3 d,无一例创面感染。传统手术组: 混合痔229例中治愈215例(93.9%),显效14例(6.1%); 内痔188例中治愈175例(93.1%),显效13例(6.9%); 术后发生出血3例,肛管狭窄12例,并发症发生率为3.6%,住院时间26.2~27.1 d。结论 对痔的环形脱垂,采用PPH手术并与外痔切除或外剥内扎方法相结合,具有手术操作简单、安全、术后疼痛轻、恢复快等特点,优于传统的外剥内扎手术。
Objective To evaluate treatment of the bleeding and prolapse of hemorrhoids by copper ion electrochemistry.Methods All patients suffered from the bleeding and prolapse of internal hemorrhoids or mixed hemorrhoids were included in this study. There were 202 patients in trial group (79 patients with internal hemorrhoids,123 patients with mixed hemorrhoids). Control group contained 171 cases (64 patients with internal hemorrhoids,107 patients with mixed hemorrhoids). There were 56 patients with prolapse of inner hemorrhoids or mixed hemorrhoids. Copper ion electrochemistry was performed in trial group. Suppository was used in control group. After the rectum was sterilized, the copper needle was inserted into the hemorrhoid with the depth about 8-15 mm. Then we continued the therapy for 4 minutes and 40 seconds. Other hemorrhoids were treated in the same way. Results The cure rate in trial group with hemorrhoidal bleeding was 98.0%,special virtual rate was 1.50%,virtual rate was 0.5%, inefficiency rate was 0 (U=44.6,Plt;0.001). The cure rate in control group was 11.1%,special virtual rate was 24.6%,virtual rate was 28.1%,inefficiency rate was 36.3%. The cure rate of prolapse group was 48.2%,special virtual rate was 33.9%,virtual rate was 17.9%. The patients didn’t feel uncomfortable and recovered 4 hours later after operation. Conclusion This therapy was safe, effective and simple.
目的 观察经肛门吻合器直肠部分切除吻合术(stapler transanal partial resection of rectum,STAPRE)治疗直肠脱垂的临床疗效。方法 笔者所在医院2005年8月至2011年2月期间对长度小于15cm的42例直肠脱垂患者行STAPRE治疗。结果 术后随访12个月者36例(其中19例超过24个月),随访6个月者6例,均未见复发。结论 STAPRE适合Ⅰ、Ⅱ及Ⅲ度直肠脱垂以及年迈和全身状况不佳的患者,可消除开腹手术带来的风险。