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比较痔切除术和 PPH 在治疗 III 度和 IV 度痔中的疗效。

Comparison of the outcomes of hemorrhoidectomy and PPH in the treatment of grades III and IV hemorrhoids.

机构信息

Department of General Surgery, Wuxi Clinical Medical School of Anhui Medical University, 904th Hospital of PLA (Wuxi Taihu Hospital, Wuxi, China.

出版信息

Medicine (Baltimore). 2022 Mar 18;101(11). doi: 10.1097/MD.0000000000029100.

Abstract

To investigate the clinical effect and outcome of traditional hemorrhoidectomy and procedures for prolapse and hemorrhoid (PPH) for the treatment of grades III and IV hemorrhoids.We retrospectively reviewed 1003 grades III and IV hemorrhoid patients who presented to our hospital. A total of 585 patients underwent PPH, and 418 patients underwent hemorrhoidectomy. The outcomes were 1-year recurrence, postoperative complications, surgery-related complications, and indicators.No significant difference between the 2 treatment groups regarding patient demographics. All patients underwent more than 12months of postoperative follow-up. No significant difference between the 2 treatment groups in 1-year recurrence. PPH can markedly improve anal pain, postoperative bleeding, difficult urination, and postoperative resting anal pressure. The operative blood loss, operative time, wound healing time, and wound infection rates were decreased significantly in the PPH group compared with the traditional hemorrhoidectomy group.Our data suggest that PPH is useful and safe for grades III and IV hemorrhoids. It can reduce postoperative and surgery-related complications. However, this was a single-hospital retrospective study. Therefore, well-designed, multicenter, randomized controlled trials are needed to evaluate the value of PPH for grades III and IV hemorrhoids.

摘要

为了探讨传统痔切除术和痔脱垂及痔(PPH)手术治疗 III 度和 IV 度痔的临床效果和结局。我们回顾性分析了 1003 例 III 度和 IV 度痔患者,其中 585 例行 PPH 手术,418 例行痔切除术。观察指标为 1 年复发率、术后并发症、手术相关并发症和手术相关指标。

两组患者的一般资料无统计学差异。所有患者均进行了 12 个月以上的术后随访。两组患者 1 年复发率无统计学差异。PPH 可明显改善肛门疼痛、术后出血、排尿困难和术后静息肛门压力。与传统痔切除术组相比,PPH 组的手术出血量、手术时间、伤口愈合时间和伤口感染率均显著降低。

我们的数据表明,PPH 治疗 III 度和 IV 度痔是有用且安全的,它可以减少术后和手术相关并发症。然而,这是一项单中心回顾性研究。因此,需要设计良好的多中心随机对照试验来评估 PPH 治疗 III 度和 IV 度痔的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5471/10684234/896754b61fdd/medi-101-e29100-g001.jpg

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