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一种治疗Ⅲ至Ⅳ期痔疮的新技术:自制肛门垫悬吊夹联合超声刀。

A novel technique for the treatment of stages III to IV hemorrhoids: Homemade anal cushion suspension clamp combined with harmonic scalpel.

作者信息

Lin Guoqiang, Ge Qiongxiang, He Xiaokang, Qi Haixin, Xu Li

机构信息

Department of Anorectal Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

出版信息

Medicine (Baltimore). 2017 Jun;96(26):e7309. doi: 10.1097/MD.0000000000007309.

Abstract

To compare the efficacy of homemade anal cushion suspension clamp combined with harmonic scalpel (ACS) and Milligan-Morgan hemorrhoidectomy combined with electric knife (MMH) in the treatment of stages III to IV hemorrhoids. We conducted a retrospective study of 99 patients with stages III to IV hemorrhoids hospitalized from January to December in 2013. Among them, 51 patients were treated with ACS, while 48 patients received MMH. Data from clinical recording and follow-up included operative time, intraoperative blood loss, hospitalization information, postoperative pain, and postoperative complications. Operative time, intraoperative blood loss and hospitalization time in ACS group were significantly less than those in MMH group (P < .05). Compared with MMH group, ACS group had a lower postoperative static pain score from days 1 to 14 (P < .01). The patients in ACS group exhibited less postoperative defecation pain scores from days 3 to 20 than those of MMH group (P < .05). The incidence of postoperative anal edema and delayed wound healing in ACS group was lower than that in MMH group (P < .05). Compared with MMH, our novel technique ACS was more effective and had fewer postoperative complications in the treatment of stages III to IV hemorrhoids.

摘要

比较自制肛门垫悬吊夹联合超声刀(ACS)与Milligan-Morgan痔切除术联合电刀(MMH)治疗Ⅲ至Ⅳ度痔的疗效。我们对2013年1月至12月住院的99例Ⅲ至Ⅳ度痔患者进行了回顾性研究。其中,51例患者接受ACS治疗,48例患者接受MMH治疗。临床记录和随访数据包括手术时间、术中出血量、住院信息、术后疼痛和术后并发症。ACS组的手术时间、术中出血量和住院时间明显少于MMH组(P<0.05)。与MMH组相比,ACS组术后1至14天的静态疼痛评分更低(P<0.01)。ACS组患者术后3至20天的排便疼痛评分低于MMH组(P<0.05)。ACS组术后肛门水肿和伤口延迟愈合的发生率低于MMH组(P<0.05)。与MMH相比,我们的新技术ACS在治疗Ⅲ至Ⅳ度痔方面更有效,术后并发症更少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1318/5500060/a26e287e0680/medi-96-e7309-g001.jpg

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