痔上黏膜环切钉合术与Milligan-Morgan术治疗重度痔的近远期疗效比较
The short-and long-term effect comparsion of procedure for prolapsed hemorrhoid and Milligan-Morgan hemorrhoidectomy in the treatment of severe hemorrhoids
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摘要: 目的：比较痔上黏膜环切钉合术(PPH)与Milligan-Morgan术(M-M)治疗重度痔的近远期疗效。方法：回顾性分析166例Ⅲ~Ⅳ期重度痔患者的临床资料及5年随访资料,M-M组和PPH组各83例。比较2组患者的近期疗效、远期并发症及复发情况。结果:2组手术时间、住院时间、住院费用、疼痛指数及术后近期并发症发生率差异有统计学意义(P0.05~P0.01)。Ⅲ期患者中,PPH组术后3年、5年复发率与M-M组差异无统计学意义(P0.05)。Ⅳ期患者中,PPH组术后3年、5年并发症发生率和术后5年的复发率均高于M-M组(P0.05)。结论：PPH治疗Ⅲ、Ⅳ期重度痔的近期疗效优于M-M,但远期并发症及复发率较高。对于Ⅲ期脱垂性内痔或以内痔为主的混合痔宜选择PPH治疗,而对于Ⅳ期重度痔及以外痔为主的混合痔则应考虑以M-M进行治疗。
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关键词:
- 痔 /
- 痔上黏膜环切钉合术 /
- Milligan-Morgan术 /
- 疗效
Abstract: Objective: To compare the short- and long-term effects of procedure for prolapsed and hemorrhoid(PPH) and Milligan-Morgan hemorrhoidecObjective: Tomy(M-M) in the treatment of severe hemorrhoids. Methods: One hundred and sixty-six patients with grade Ⅲand Ⅳ hemorrhoids were followed up for 5 years， and divided inObjective: To PPH and M-M group(83 cases each group). The short-term effects，long-term complications and recurrence in two groups were compared. Results: The differences of the time of operation and hospitalization stay，hospitalization expense，pain index and incidence of short-term complication between PPH and M-M group were statistically significant(P ＜ 0. 05 Objective: To P ＜ 0. 01). The differences of the recurrence rates between PPH group and M-M group with grade Ⅲ in 3 and 5 years after operation had no statistical significance (P ＜ 0. 05). The recurrence rate of 5 years after operation and incidence of complications of 3 and 5 years after operation in PPH group with grade Ⅳ were higher than those in M-M group(P ＜0. 05). Conclusions: The short-term effects of PPH in the treatment of grade Ⅲ and Ⅳ hemorrhoids are better than those in M-Mgroup，but their long-term complications and recurrence rates are high. The PPH treatment is fit for the patients with grade Ⅲ prolapsedinternal hemorrhoids and mixed hemorrhoid which is mainly composed of internal hemorrhoids. The M-M treatment is fit for the patientswith grade Ⅳ hemorrhoids and mixed hemorrhoid which is mainly composed of external hemorrhoids. -
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