改良Milligan-Morgan 术联合肛垫悬吊和部分内括约肌切除术治疗环状混合痔
Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection for circumferential mixed hemorrhoids.
机构信息
Department of General Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.
出版信息
World J Gastroenterol. 2013 Aug 14;19(30):5011-5. doi: 10.3748/wjg.v19.i30.5011.
AIM
To identify a more effective treatment protocol for circumferential mixed hemorrhoids.
METHODS
A total of 192 patients with circumferential mixed hemorrhoids were randomized into the treatment group, where they underwent Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection, or the control group, where traditional external dissection and internal ligation were performed. Postoperative recovery and complications were monitored.
RESULTS
The time to wound healing was 12.96 ± 2.25 d in the treatment group shorter than 19.58 ± 2.71 d in the control group. Slight pain rate was 58.3% in the treatment group higher than 22.9% in the control group; moderate pain rate was 33.3% in the treatment group lower than 56.3% in the control group severe pain rate was 8.4% in the treatment group lower than 20.8% in the control group. No edema rate was 70.8% in the treatment group higher than 43.8% in the control group; mild local edema rate was 26% in the treatment group lower than 39.6% in the control group obvious local edema was 3.03% in the treatment group lower than 16.7% in the control group. No stenosis rate was 85.4% in the treatment group higher than 63.5% in the control group; moderate stenosis rate was 14.6% in the treatment group Lower than 27.1% in the control group severe anal stenosis rate was 0% in the treatment group lower than 9.4% in the control group.
CONCLUSION
Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection is the optimal treatment for circumferential mixed hemorrhoids and can be widely applied in clinical settings.
目的
确定一种更有效的环状混合痔治疗方案。
方法
将 192 例环状混合痔患者随机分为治疗组（行吻合器痔上黏膜环切术+肛门垫悬吊术+部分内括约肌切除术）和对照组（行传统外剥内扎术），观察术后恢复情况及并发症。
结果
治疗组创面愈合时间为 12.96±2.25d，短于对照组的 19.58±2.71d；治疗组轻微疼痛率为 58.3%，高于对照组的 22.9%；中度疼痛率为 33.3%，低于对照组的 56.3%；重度疼痛率为 8.4%，低于对照组的 20.8%。治疗组无水肿率为 70.8%，高于对照组的 43.8%；轻度局部水肿率为 26%，低于对照组的 39.6%；明显局部水肿率为 3.03%，低于对照组的 16.7%。治疗组无狭窄率为 85.4%，高于对照组的 63.5%；中度狭窄率为 14.6%，低于对照组的 27.1%；重度肛门狭窄率为 0%，低于对照组的 9.4%。
结论
吻合器痔上黏膜环切术+肛门垫悬吊术+部分内括约肌切除术是环状混合痔的最佳治疗方法，值得临床推广应用。
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