Herold A
Enddarm-Zentrum Mannheim, Bismarckplatz 1, 68165 Mannheim.
Chirurg. 2006 Aug;77(8):737-47; quiz 748. doi: 10.1007/s00104-006-1215-2.
Hemorrhoidal disease is one of the most frequent disorders in western countries. The aim of individual therapy is freedom from symptoms achieved by normalisation of anatomy and physiology. Treatment is orientated to the stage of disease: haemorrhoids 1 are treated conservatively. In addition to high-fibre diet, sclerotherapy is used. Haemorrhoids 2 prolapse during defecation and return spontaneously. First-line treatment is rubber band ligation. Haemorrhoids 3 that prolapse during defecation have to be digitally reduced, and the majority need surgery. For segmental disorders, haemorrhoidectomy according to Milligan-Morgan or Ferguson is recommended. In circular disease, Stapler hemorrhoidopexy is now the procedure of choice. Using a therapeutic regime according to the hemorrhoidal disease classification offers high healing rates and low rates of complications and recurrence.
痔病是西方国家最常见的疾病之一。个体化治疗的目标是通过解剖和生理功能的正常化实现症状缓解。治疗方法根据疾病阶段而定：1度痔采用保守治疗。除高纤维饮食外，还可采用硬化剂注射治疗。2度痔在排便时脱出并能自行回纳。一线治疗方法是橡皮圈套扎术。3度痔在排便时脱出，需用手指推回，大多数需要手术治疗。对于节段性病变，推荐采用Milligan-Morgan或Ferguson痔切除术。对于环状病变，吻合器痔上黏膜环切术是目前的首选术式。根据痔病分类采用相应的治疗方案可获得较高的治愈率、较低的并发症发生率和复发率。
