CAJ | 학술논문

目的：探讨吻合器痔上黏膜环切术加肛瘘切除术治疗重度混合痔合并肛瘘的临床疗效。方法将60例混合痔合并肛瘘患者随机分成吻合器痔上黏膜环切术加肛瘘切除术组（观察组）和外剥内扎加肛瘘切除术组（对照组），每组30例。观察和比较2组手术时间、住院时间、术中出血量、术后出血、尿潴留、肛门坠胀及水肿、术后疼痛时间、术后控便能力下降、感染、术后复发等情况。结果观察组手术时间、术中出血量、术后出血、术后疼痛时间、术后控便能力下降、肛门坠胀及水肿、住院时间优于对照组，差异有统计学意义（P值均小于0．05）；2组在尿潴留、感染、肛瘘复发等方面的差异均无统计学意义（ P值均大于0．05）。结论 PPH加肛瘘切除术治疗重度痔疮合并单纯性肛瘘是安全可行的术式。
목적：탐토문합기치상점막배절술가항루절제술치료중도혼합치합병항루적림상료효。방법장60례혼합치합병항루환자수궤분성문합기치상점막배절술가항루절제술조（관찰조）화외박내찰가항루절제술조（대조조），매조30례。관찰화비교2조수술시간、주원시간、술중출혈량、술후출혈、뇨저류、항문추창급수종、술후동통시간、술후공편능력하강、감염、술후복발등정황。결과관찰조수술시간、술중출혈량、술후출혈、술후동통시간、술후공편능력하강、항문추창급수종、주원시간우우대조조，차이유통계학의의（P치균소우0．05）；2조재뇨저류、감염、항루복발등방면적차이균무통계학의의（ P치균대우0．05）。결론 PPH가항루절제술치료중도치창합병단순성항루시안전가행적술식。
Objective To explore the efficacy of the procedure for prolapse and hemorrhoids ( PPH) combined with fistu-lectomy in treatment of severe hemorrhoids complicated with anal fistula .Methods 60 patients with severe hemorrhoids com-plicated with anal fistula admitted for surgical treatment were randomly divided into a PPH plus fistulectomy group ( investiga-tion group ) and a milligan-morgan plus fistulectomy group ( control group ) ,30 cases for each .The two groups were observed and compared in terms of operating time,hospitalization time,intraoperative blood loss,postoperative bleeding,urinary reten-tion,anus belly,postoperative pain time and the ability of controlling feces ,infection,postoperative recurrence ,and so on.Re-sults There were no significant differences between the 2 groups in urinary retention ,infection,and postoperative recurrence ( P>0.05 ) .The investigation group was superior to the control group in operating time , hospitalization time , intraoperative blood loss,postoperative bleeding,anus belly,postoperative pain time and the ability of controlling feces (P<0.05).Conclu-sion The treatment of severe hemorrhoids complicated with simple anal fistula with PPH plus anal fistula resection is safe and feasible.