CAJ | 학술논문

目的：探讨吻合器痔上黏膜环切术（PPH）治疗接受抗凝剂治疗的内痔患者的安全性和临床疗效。方法2009年1月～2011年12月我们对36例由于患有心血管疾病长期接受抗凝剂治疗患者（抗凝组）和49例未接受抗凝治疗（对照组）的内痔患者施行PPH术。比较两组患者的手术时间、住院时间、术中和术后出血、肛门疼痛、肛门狭窄、肛门失禁、住院期间心脑血管疾病的发生率。结果抗凝组和对照组患者术中出血量分别为15．8±1．9 mL和29．8±3．4 mL （t＝22．7，P＜0．05），出血较多分别抗凝组有1例（2．8％）、对照组有2例（4．1％），3例患者估计出血量约200～500 mL，给予正确处理措施后彻底止血，无一例输血；术后无一例发生心脑血管疾病意外。手术时间、术后并发症和住院时间等比较无明显差别（P＞0．05）。结论对于接受抗凝治疗的内痔患者，PPH手术的疗效与安全性均与正常接受PPH手术患者无明显差别。
목적：탐토문합기치상점막배절술（PPH）치료접수항응제치료적내치환자적안전성화림상료효。방법2009년1월～2011년12월아문대36례유우환유심혈관질병장기접수항응제치료환자（항응조）화49례미접수항응치료（대조조）적내치환자시행PPH술。비교량조환자적수술시간、주원시간、술중화술후출혈、항문동통、항문협착、항문실금、주원기간심뇌혈관질병적발생솔。결과항응조화대조조환자술중출혈량분별위15．8±1．9 mL화29．8±3．4 mL （t＝22．7，P＜0．05），출혈교다분별항응조유1례（2．8％）、대조조유2례（4．1％），3례환자고계출혈량약200～500 mL，급여정학처리조시후철저지혈，무일례수혈；술후무일례발생심뇌혈관질병의외。수술시간、술후병발증화주원시간등비교무명현차별（P＞0．05）。결론대우접수항응치료적내치환자，PPH수술적료효여안전성균여정상접수PPH수술환자무명현차별。
Objective To evaluate the efficacy and safety of surgical procedure for prolapse and hemorrhoids (PPH) in patients treating with anticoagulant (anticoagulated group). Methods From Jan 2009 to Dec 2011,36 patients with cardiovascular diseases treated with anticoagulant and 49 patients without anticoagulated therapy (control group) were included in this study. All patients underwent procedure for prolapse and hemorrhoids. A comparison was done between the two groups in terms of the following items: operation time, intraoperative and postoperative blood loss and the incidence of cardiovascular and cerebrovascular diseases,postoperative cure rate of prolapse and bleeding, significant postoperative anal pain,incontinence,anal stenosis,and hospital stay. Results All patients were cured. The differences between the anticoagulated group and control group were significant in terms of and postoperative blood loss(P<0.05),and no significant differences were noted in other items. Postoperative hemorrhage with a volume of 200ml to 500 ml happened in one case in anticoagulated group and 2 cases in control group, and were cured by conservative treatment. No case needed blood transfusion. Conclusion It is safe and effective for patients with cardiovascular diseases treated with anticoagulant.