CAJ | 학술논문

目的比较痔上黏膜环切钉合术(PPH)与Milligan-Morgan术(MMH)治疗Ⅲ、Ⅳ度内痔的远期疗效.方法按照完全随机分组原则将100例Ⅲ、Ⅳ度内痔患者分别采用PPH(PPH组,42例)和MMH(MMH组,58例)手术,观察并比较两组患者术后的远期疗效差异.结果 PPH组与MMH组术后2年比较,在出现肛门溢液(2.38%比20.69%,P=0.007)、皮赘(9.52%比25.86%,P=0.040)和细便(2.38%比18.97%,P=0.027)方面PPH组术后少见,总的并发症发生率(9.52%比25.86%,P=0.040)和总排便功能异常(9.52%比29.31%,P=0.017)方面PPH组术后也少见,两组差异有统计学意义.在痔脱垂复发(14.29%比10.34%,P=0.549)、症状改善满意度(92.86%比87.93%,P=0.636)和总的症状复发(19.05%比25.86%,P=0.424)方面两组差异无统计学意义.结论 PPH与Milligan-Morgan术治疗Ⅲ、Ⅳ度内痔的远期疗效无显著差异,但PPH安全、并发症少、对排便功能影响小.
목적 비교치상점막배절정합술(PPH)여Milligan-Morgan술(MMH)치료Ⅲ、Ⅳ도내치적원기료효.방법 안조완전수궤분조원칙장100례Ⅲ、Ⅳ도내치환자분별채용PPH(PPH조,42례)화MMH(MMH조,58례)수술,관찰병비교량조환자술후적원기료효차이.결과 PPH조여MMH조술후2년비교,재출현항문일액(2.38%비20.69%,P=0.007)、피췌(9.52%비25.86%,P=0.040)화세편(2.38%비18.97%,P=0.027)방면PPH조술후소견,총적병발증발생솔(9.52%비25.86%,P=0.040)화총배편공능이상(9.52%비29.31%,P=0.017)방면PPH조술후야소견,량조차이유통계학의의.재치탈수복발(14.29%비10.34%,P=0.549)、증상개선만의도(92.86%비87.93%,P=0.636)화총적증상복발(19.05%비25.86%,P=0.424)방면량조차이무통계학의의.결론 PPH여Milligan-Morgan술치료Ⅲ、Ⅳ도내치적원기료효무현저차이,단PPH안전、병발증소、대배편공능영향소.
Objective To compare the long-term efficacy of procedure for prolapse and hemorrhoids (PPH) and Milligan-Morgan hemorrhoidectomy (MMH) in the treatment of Ⅲ and Ⅳdegree internal hemorrhoids. Methods One hundred patients were randomly divided into two groups and received PPH (n=42) and MMH (n=58) respectively. After two years, the efficacy, complications and function of defecation were compared. Results Two years after operation, the morbidities of hydrorrhea (2.38% vs 20.69%, P=0.O07), dermal neoplasm formation (9.52% vs 25.86%, P=0.040) and narrowing in the caliber of the stools (2.38% vs 18.97%, P=0.027) were significantly lower in PPH group than those in MMH group (P＜0.05). The morbidities of overall complication (9.52% vs 25.86%, P=0.040) and overall abnormal function of defecation (9.52% vs 29.31%, P=0.017) were lower in PPH group than those in MMH group (P＜0.05). However, there were no significant differences of the morbidity of relapse (14.29% vs 10.34%, P=0.549), patient satisfactory degree (92.86% vs 87.93%, P=0.636) and overall symptom recurrence rate (19.05% vs 25.86%,P=0.424) between the two groups. Conclusions Long-term efficacies of procedure for prolapse and hemorrhoids and Milligan-Morgan haemorrhoidectomy in the treatment of Ⅲ and Ⅳ degree internal hemorrhoids are similar. PPH has better safety, less complications and less effect on abnormal function of defecation compared with MMH.