CAJ | 학술논문

目的初步探讨痔上黏膜环形切除钉合术(Procedure for Prolapse and Hemorrhoids,PPH)单荷包缝合、双荷包缝合以及调节两倚包间距离对切除直肠黏膜宽度的影响,为临床医师制订个体化治疗方案及更好地开展PPH术提供依据.方法符合纳入标准的Ⅲ～Ⅳ期内痔28例,随机分为2组:单荷包缝合组15例,双荷包缝合组13例.分别对2组患者术中所切除直肠黏膜的宽度进行测量、记录.切除标本送病理检查,检查其是否带肌层.并对2组患者术后的临床疗效、并发症(出血、疼痛、尿潴留、急便感)进行统计学分析和比较.结果 2组间短期临床疗效、术后并发症(出血、疼痛、尿潴留)、切除组织是否带肌层的比较,差异均无统计学意义(P>0.05),但对2组间术中所切除黏膜环宽度进行比较发现双荷包缝合组所切除黏膜环的宽度明显大于单荷包缝合组,差异有统计学意义(P<0.01). 结论单荷包缝合、双荷包缝合以及两荷包间距离可以控制PPH术切除黏膜环的宽度.
목적 초보탐토치상점막배형절제정합술(Procedure for Prolapse and Hemorrhoids,PPH)단하포봉합、쌍하포봉합이급조절량의포간거리대절제직장점막관도적영향,위림상의사제정개체화치료방안급경호지개전PPH술제공의거.방법 부합납입표준적Ⅲ～Ⅳ기내치28례,수궤분위2조:단하포봉합조15례,쌍하포봉합조13례.분별대2조환자술중소절제직장점막적관도진행측량、기록.절제표본송병리검사,검사기시부대기층.병대2조환자술후적림상료효、병발증(출혈、동통、뇨저류、급편감)진행통계학분석화비교.결과 2조간단기림상료효、술후병발증(출혈、동통、뇨저류)、절제조직시부대기층적비교,차이균무통계학의의(P>0.05),단대2조간술중소절제점막배관도진행비교발현쌍하포봉합조소절제점막배적관도명현대우단하포봉합조,차이유통계학의의(P<0.01). 결론 단하포봉합、쌍하포봉합이급량하포간거리가이공제PPH술절제점막배적관도.
Objective Extrapolate the relationships between the width of circumferential rectal mucosa re-sected and the method of either performing single purse-string or performing double purse-string during per-forming the procedure for prolapse and hemorrhoids (PPH), and to assess the impact of both the level of sta-ple line and the width of rectal mucosa resected on clinical outcomes after stapled hemorrhoidpexy. Meth-ods Twenty-eight adult patients with Ⅲ-Ⅳ hemorrhoids were assigned to two groups: 15 patients using sin-gle pursestring and the remaining 13 patients using double purse-string. The mucosal width of doughtnuts of both groups were measured and the data recorded. The doughtnuts resected were sent to pathology examina-tion after stapled hemorrhoids pexy to identify whether or not the specimens involved the smoth muscles. The demographic complications (bleeding, postoperative pain, urinary retention, fecal urgency) were compared and statistically analysed between the two groups, respectively. Results There were no statistical differ-ences between the two groups in terms of postoperative short-term results and complication rates, as well as the proportion of involving smooth muscle in specimens(P >0.05). However, when compared the width of doughtnuts resected in single-pursestring group was smaller than that in double-parse-string group (P < 0. 01). Conclusion The single or double-purse-string suture in PPH can control the width of resected rectal mucosa.