【摘要】 目的比较重度脱垂性痔环形切除术与吻合器痔上黏膜环形切除术(PPH)治疗Ⅲ、Ⅳ度环形内痔的临床效果。方法将96例Ⅲ、Ⅳ度环形内痔患者随机分为两组,每组各48例,A组采用重度脱垂性痔环形切除术,B组采用PPH手术。观察两组患者术后症状的改善、手术时间、疼痛指数、注射止痛药次数、住院天数、住院费用等并进行比较。结果近期总的症状改善满意率:A组为94.9%,B组为96.6%;疼痛指数、注射止痛药次数B组优于A组;两组住院时间相近,B组住院费用平均为A组的2.4倍。结论PPH手术治疗Ⅲ、Ⅳ度内痔的近期治疗效果优于重度脱垂性痔环形切除术。这两种手术均适合治疗Ⅲ、Ⅳ度内痔。更多还原

【Abstract】 Objective To compare the efficacy of modified severe plolapse circumferential hemorrhoidectomy with PPH hemorrhoidectomy in patients with Ⅲor Ⅳdegree circumferential hemorrhoids. Methods Ninety-eight patients with grade Ⅲor grade Ⅳhemorrhoids were randomly assigned to modified circumferential hemorrhoidectomy (n=48) and stapled hemorrhoidectomy (n=48). The operating time, frequency of postoperative analgesic injection,time to return to normal activity, symptom relief, quality of life, patient satisfaction, total related medical costs, hospital stay and postoperative complications were evaluated. Results Short-term satisfaction of symptom relief is 94.9 percent in modified circumferential hemorrhoidectomy group, 96.9 percent in stapled group. Mean pain intensity was less in stapled group. There were no significant differences in the total number of complications, the length of absence from work or control of symptoms. The average cost of treatment in stapled group was 2.4 times higher than that in circumferential hemorrhoidectomy group. Conclusions Short-term efficiency is similar between two groups. These two methods are all suitable for grade Ⅲor grade Ⅳcircumferential internal hemorrhoids.更多还原