CAJ | 학술논문

目的比较痔上黏膜环切术(PPH)、PPH+选择性痔核外剥内扎术(MMH)治疗Ⅲ～Ⅳ度痔的临床效果,探讨治疗Ⅲ～Ⅳ度痔的最佳术式.方法回顾性分析125例Ⅲ～Ⅳ度痔经手术治疗患者的临床资料,非随机对照分为PPH治疗组(1组)、PPH+选择性痔核MMH治疗组(2组),分别采用PPH术式和PPH+选择性痔核MMH术式治疗,观察术后复发率、并发症和肛门坠胀感、出血、肿块脱出、肛门瘙痒、肛门潮湿等症状缓解情况.结果术后观察3年,两组均明显缓解了脱垂、便血及肛门下坠感、肛门潮湿、肛门瘙痒等症状,缓解率均达92%以上.1组术后复发8例,复发率13%；2组术后复发1例,复发率2%,两组复发率差异有统计学意义(x2=4.629,P＜0.05).结论应首选PPH+选择性痔核MMH术式治疗Ⅲ～Ⅳ度痔,既能最大程度减少痔症状,又取得更好的远期治疗效果.
목적 비교치상점막배절술(PPH)、PPH+선택성치핵외박내찰술(MMH)치료Ⅲ～Ⅳ도치적림상효과,탐토치료Ⅲ～Ⅳ도치적최가술식.방법 회고성분석125례Ⅲ～Ⅳ도치경수술치료환자적림상자료,비수궤대조분위PPH치료조(1조)、PPH+선택성치핵MMH치료조(2조),분별채용PPH술식화PPH+선택성치핵MMH술식치료,관찰술후복발솔、병발증화항문추창감、출혈、종괴탈출、항문소양、항문조습등증상완해정황.결과 술후관찰3년,량조균명현완해료탈수、편혈급항문하추감、항문조습、항문소양등증상,완해솔균체92%이상.1조술후복발8례,복발솔13%；2조술후복발1례,복발솔2%,량조복발솔차이유통계학의의(x2=4.629,P＜0.05).결론 응수선PPH+선택성치핵MMH술식치료Ⅲ～Ⅳ도치,기능최대정도감소치증상,우취득경호적원기치료효과.
Objective To compare the clinical outcome of procedure for prolapse and hemorrhoids (PPH) and PPH + selective Milligan-Morgan hemorrhoidectomy(MMH) in surgical treatment of Ⅲ ～ Ⅳ stage hemorrhoids and research the best surgical procedures.Methods Retrospective analysis was made on the clinical data of 125 cases with Ⅲ ～ Ⅳ stage mixed hemorrhoids,they were non-randomized-controlled divided into PPH group (group 1) and PPH + selective MMH group(group 2),comparing the data of recurrence,complication and symptoms relief including anal prolapse,bleeding,anus fall feeling,wet anus and pruritus ani.Results While observing 3 years after operation,group 1 and group 2 both relieved symptoms of anal prolapse,bleeding,anus fall feeling,wet anus and pruritus ani.The relief rate of these symptoms in the two group were all high than 92%.There was one cases relapsed in the group 2 (the recurrence rate of 2%) was better than the group 1 (the recurrence rate of 13%) which were 8 case,there was a significant statistical significance (x2 =4.629,P ＜ 0.05) in the recurrence and clinical outcome.Conclusion Radical choose of PPH and selective MMH to treat Ⅲ ～ Ⅳ stage mixed hemorrhoids patients,which could relieve postoperative symptoms and acquire better long-term clinic outcomes.