CAJ | 학술논문

目的探讨吻合器痔上黏膜环切术(PPH)治疗老年人重度痔的围手术期处理及其临床疗效. 方法回顾性分析行PPH手术治疗52例老年患者的临床资料. 结果 52例手术均获成功,平均手术时间(15.3±3.2)min,平均失血量(15±1.7)ml,平均住院(4.5±2.6)d.随访1～20个月,平均随访(14.2±2.4)个月,随访48例,随访率92.3%,术后尿潴留18例(37.5%);吻合口出血2例(4.2%);肛门疼痛4例(8.4%);复发1例(2.1%);低血糖1例(2.1%);1例(2.1%)于术后第2个月出现吻合口狭窄,无直肠阴道瘘病例. 结论年龄不是PPH治疗重度痔病的手术禁忌证,重视围手术期处理可以减少术后并发症,提高生活质量.
목적 탐토문합기치상점막배절술(PPH)치료노년인중도치적위수술기처리급기림상료효. 방법회고성분석행PPH수술치료52례노년환자적림상자료. 결과 52례수술균획성공,평균수술시간(15.3±3.2)min,평균실혈량(15±1.7)ml,평균주원(4.5±2.6)d.수방1～20개월,평균수방(14.2±2.4)개월,수방48례,수방솔92.3%,술후뇨저류18례(37.5%);문합구출혈2례(4.2%);항문동통4례(8.4%);복발1례(2.1%);저혈당1례(2.1%);1례(2.1%)우술후제2개월출현문합구협착,무직장음도루병례. 결론년령불시PPH치료중도치병적수술금기증,중시위수술기처리가이감소술후병발증,제고생활질량.
Objective To evaluate the perioperative management and therapeutic efficacy of procedure for prolapse and hemorrhoids (PPH) in elderly patients with serious hemorrhoids. Methods The clinical data of 52 elderly patients (aged 60 years or over) with serious hemorrhoids treated by PPH from March 2005 to November 2007 were analyzed restrospectively. Results All the operations were successfully completed. The average operation time was (15.3±3.2) min, the average blood loss was (15±1.7) ml and the average hospitalization time was (4.5±2.6) days.Patients were followed for 1-20 months with (14.2±2.4) months for average. The follow-up rate was 92.3%(48/52). Complications included urinary retention in 18 cases(37.5%), anastomotic bleedings in 2 cases (4.2%), postoperative pain of anus in 4 cases (8.4%), recurrence in 1 case (2.1%),hypoglycemia in 1 case(2.1%), and 1 case (2.1%)was found stricture in rectum at 2 months after the procedure and no case developed rectovaginal fistula. Conclusions Old age is not the contraindication for PPH treatment of the serious hemorrhoids. Proper perioperative management may decrease the postoperative complications and improve the life quality of the patients.