两种微创术式治疗老年混合痔的临床疗效比较

目的:比较两种微创手术方式治疗老年混合痔的临床疗效和安全性。方法:选取2012年10月至2013年4月在湖南中医药大学第一附属医院肛肠科住院的162例老年混合痔患者并随机分成治疗组82例和对照组80例,治疗组采用自动痔疮套扎(RPH)术+外痔切除术治疗,对照组采用痔上粘膜环切钉合(PPH)术+外痔切除术治疗,观察周期为21天,随访3年。观察并比较分析两组患者术后疼痛积分、手术时间、术中出血量、术后恢复时间、术后并发症情况及远期疗效。结果:治疗组手术时间、术中出血量、术后恢复时间、术后24 h疼痛积分、首次排便疼痛积分及术后并发症(出血、水肿)的发生率均明显短于或低于对照组,差异有统计学意义(P0.05)。两组的远期疗效相当,差异无统计学意义(P0.05)。结论:自动痔疮套扎(RPH)术治疗老年混合痔患者的近期疗效和安全性较粘膜环切钉合(PPH)术+外痔切除术更好,而远期疗效与其相当。

Comparison of the Clinical Efficacy of Two Kinds of Minimally Invasive Surgery in the Treatment of Elderly Patients with Mixed Hemorrhoids

ABSTRACT Objective: To compare the clinical efficacy and safety of two kinds of minimally invasive surgery in the treatment of elderly patients with mixed hemorrhoids. Methods: From October 2012 to April 2013, 162 cases of elderly patients with mixed hemorrhoids in the anorectal Hospital of the First Affiliated Hospital of Hunan University of Chinese Medicine were randomly divided into the treatment group(82 cases) and control group(80 cases), treatment group adopted automatic hemorrhoids ligation (RPH) surgery + external hemorrhoids resection treatment, control group with hemorrhoids stapling operation (PPH) + external hemorrhoids resection, the observation period was 21 days, 3 years of follow-up. The postoperative pain score, operation time, blood loss, postoperative recovery time, postoperative complications and long-term efficacy of the two groups were observed and compared. Results: The operation time, intraoperative bleeding, postoperative recovery time, postoperative pain, 24 h score after the first defecation pain score and postoperative complications (bleeding, edema) incidence of treatment group were significantly shorter or lower than those of the control group(P<0.05). No significant difference was found in the long-term efficacy between two groups(P>0.05). Conclusion: The short-term efficacy and safety of automatic hemorrhoid ligation (RPH) in treatment of elderly patients with mixed hemorrhoids was better than the mucosal ring cutting stapling (PPH) surgery + external hemorrhoids resection, but the long-term effects were equal.