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[内痔的病理特征及其临床意义]

[The pathological characters and its clinical significance of internal hemorrhoids].

作者信息

Wang Zhen-jun, Tang Xiu-ying, Wang Dong, Zhao Bo, Han Wei, Yang Xin-qing, Huang Yan-ting

机构信息

Department of General Surgery, Capital University of Medical Sciences Affiliated Beijing Chaoyang Hospital, Beijing 100020, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2006 Feb 1;44(3):177-80.

Abstract

OBJECTIVE

To investigate the pathological characters and the corresponding clinical significance of internal hemorrhoids tissues.

METHODS

Normal anal cushion and internal haemorrhoids tissue samples were obtained after stapled haemorrhoidectomy procedure from 24 grade III hemorrhoidal patients. The macroscopically normal cushions served as own controls and the normal cushions from a patient without a history of haemorrhoids as quality control. Routine Hematoxylin-Eosin and orcein were performed for elastic fibers.

RESULTS

Compared with the corresponding normal anal cushions, the subepithelial vessels especially the cavernous vessels of the hemorrhoidal tissues showed obvious structural impair, retrograde changes, and the internal elastic lamina were ruptured and discontinuous. In addition, thrombosis and subsequent ischemic changes were observed. The Trietz's muscle and the fibro-elastic tissues showed hypertrophy, distortion, rupture and tortility. Obvious mucosal injury was observed in the mucous of hemorrhoidal tissues. Venous dilatation was infrequent in the hemorrhoidal tissues.

CONCLUSIONS

The anal cushions of hemorrhoids disease patients show significant pathological changes. The pathological changes include structural impair, retrograde changes of the cavernous vessels and the hypertrophy, distortion, rupture and tortility of the Trietz's muscle and the fibroelastic tissues, and mucosal injury of the mucous membranes. These pathological changes are the basis of pathogenesis and development of hemorrhoids.

摘要

目的

探讨内痔组织的病理特征及其相应的临床意义。

方法

选取24例Ⅲ度痔患者,在吻合器痔上黏膜环切术术后获取正常肛垫及内痔组织样本。肉眼观察正常的肛垫作为自身对照,选取无痔病史患者的正常肛垫作为质量控制对照。对弹性纤维进行常规苏木精-伊红染色及地衣红染色。

结果

与相应的正常肛垫相比,痔组织的上皮下血管尤其是海绵状血管呈现明显的结构损害、逆行性改变,内弹性膜破裂且不连续。此外,观察到血栓形成及随后的缺血性改变。Treitz肌和纤维弹性组织表现为肥大、扭曲、断裂及迂曲。在痔组织的黏膜中观察到明显的黏膜损伤。痔组织中静脉扩张不常见。

结论

痔病患者的肛垫呈现显著的病理改变。这些病理改变包括结构损害、海绵状血管的逆行性改变以及Treitz肌和纤维弹性组织的肥大、扭曲、断裂及迂曲,还有黏膜的黏膜损伤。这些病理改变是痔发病机制和发展的基础。

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