【摘要】 目的探讨吻合器痔上黏膜钉合术(PPH)术中、术后出血的原因和对策。方法2004年5月至2008年12月对108例Ⅲ、Ⅳ度内痔病人行PPH术,分析术中、术后出血的原因和对策。结果术中吻合口即刻出血53例,其中吻合口明显渗血33例(30.6%),搏动性出血16例(14.8%),吻合口撕裂4例(3.7%),均在直视下缝合止血。术后少量便血28例(25.9%),明显出血5例(4.6%),其中3例再次手术止血。结论出血是PPH主要并发症之一,术前充分准备,术中正确操作、认真检查吻合口并可靠止血,术后合理治疗,在预防和处理PPH手术出血中有着重要的临床意义。更多还原

【Abstract】 Objective To assess the causes and countermeasures for bleeding in procedure for prolapse and hemorrhoids(PPH).Methods One hundred and eight cases of Ⅲ-and-Ⅳ-degree hemorrhoids were treated with PPH from May 2004 to December 2008.The causes and countermeasures for bleeding were analyzed.Results Immediate bleeding at anastomotic site occurred in 53 cases including 33 cases with obvious anastomotic bleeding,16 cases with pulsatile bleeding,and 4 cases with anastomotic tear.All of them were sutured under direct vision with cessation of bleeding.A small amount of postoperative bleeding occurred in 28 cases,obvious postoperative bleeding occurred in 5 cases,and reoperation for cessation of bleeding was taken in 3 of them.Conclusion Bleeding is one of the main complications of PPH.Full preparation before surgery,correct procedure,careful examination of anastomotic site and reliable hemostasis are important measures for prevention PPH bleeding,and reasonable treatment after operation is of great clinical significance in treatment of PPH bleeding.更多还原