自动弹力线痔疮套扎器联合外痔切除术治疗混合痔的临床疗效分析

晁忠++郭红飞

[摘要] 目的 探讨自动弹力线痔疮套扎器联合外痔切除术治疗混合痔的临床疗效。 方法 方便选取2015年1月—2016年1月该院收治的混合痔患者208例，对其临床资料进行回顾性分析。其中102例患者采用外剥内扎术进行治疗，将其设定为对照组，其中106例患者采用自动痔疮套扎术联合外痔切除术进行治疗，将其设定为观察组，比较两组临床治疗总有效率，创面愈合时间以及并发症发生情况。结果 观察组治疗后的治疗总有效率为98.11%，高于对照组的96.07%，但差异无统计学意义（P>0.05）；观察组创面愈合时间为（12.14±1.14）d，短于对照组的（16.48±2.03）d，差异有统计学意义（P<0.05）；且观察组的术后肛门疼痛（7.55% vs 18.63%），切缘水肿（6.60% vs 19.61%），以及便血发生率（11.32% vs 19.61%）均低于对照组，差异有统计学意义（P<0.05）。结论 自动弹力线痔疮套扎器联合外痔切除术治疗混合痔的临床疗效显著，安全性高，值得在临床上推广应用。

[关键词] 混合痔；自动弹力线痔疮套扎器；外痔切除术；临床疗效

[中图分类号] R657 [文献标识码] A [文章编号] 1674-0742（2017）05（b）-0110-03

[Abstract] Objective To study the clinical curative effect of automatic ligation and external hemorrhoid resection in treatment of mixed hemorrhoid. Methods 208 cases of patients with mixed hemorrhoid admitted and treated in our hospital from January 2015 to January 2016 were convenient selected and the clinical data were retrospectively analyzed and 102 cases in the control group were treated with automatic ligation， and 106 cases in the observation group were treated with automatic ligation and external hemorrhoid resection， and the total clinical treatment effective rate， wound healing time and occurrence of complications were compared between the two groups. Results After treatment， the total effective rate in the observation group was higher than that in the control group（98.11% vs 96.07%）， and the difference was not statistically significant（P>0.05）， and the wound healing time was shorter than that in the control group[（12.14±1.14）d vs （16.48±2.03）d]， and the difference was statistically significant（P>0.05）， and the incidence rate of postoperative anus pains， incisal edge edema and hemafecia in the observation group were lower than that in the control group[（7.55% vs 18.63%），（6.60% vs 19.61%），（11.32% vs 19.61%）]， and the differences were statistically significant（P<0.05）. Conclusion The clinical curative effect of automatic ligation and external hemorrhoid resection in treatment of mixed hemorrhoid is obvious with high safety， which is worth clinical promotion and application in clinic.

[Key words] Mixed hemorrhoid； Automatic ligation； External hemorrhoid resection； Clinical curative effect

痔屬于一种肛肠疾病，在临床上具有较高的发病率，痔的发病机制目前尚无统一定论，目前医学界大多数学者均支持两种学说，一种为静脉曲张学说，另一种为肛垫下移学说[1]。其中又以Thomson提出的肛垫下移学说为主。肛垫下移学说认为肛垫的组成结构包括机体肛管内壁黏膜，纤维支持结构以及血管，其属于一种正常组织，当肛垫组织由于某种原因发生了异常合并，同时导致临床症状出现时就演变成了痔[2]。痔的治疗方法包括两种，手术疗法以及非手术疗法，有资料显示，在我国临床上有64.1%的内痔患者应用非手术疗法进行治疗，在国外这一比例超过90.0%，在医学水平较为发达的欧美国家，对内痔开展治疗时主要采用套扎法进行治疗[3]。因……