混合痔手术治疗技术新进展

：痔(Haemorrhoids)是直肠末端黏膜、肛管皮肤下痔静脉丛屈曲或扩张而形成的柔软静脉团，是外科常见的疾病。尽管保守治 疗适用于大部分患者人群，但是手术治疗却适用于大部分严重病人，比如外剥内扎术就被视为治疗IV 度痔的金标准。痔的手术 治疗有传统手术和微创手术，为了减轻患者的痛苦、加速恢复、减少并发症的发生，PPH 和TST 等新型手术方式也逐渐被应用于 III痔的治疗中，这些手术方法的目的是纠正痔疮的病因及病理生理基础，具有微创、痛苦小的特点，但往往复发率较高。随着手术 方式的改进以及操作技术的成熟，痔的外科治疗效果也取得了长足的进步。本文对混合痔的外科手术技术作一综述，为临床治疗 提供理论依据。

New Progress in the Surgical Management of Haemorrhoids

Hemorrhoids is the terminal rectum mucosa, anal skin hemorrhoid venous plexus buckling or expansion and the formation of soft vein group, is the common surgical disease. Although conservative treatment based on dietary and lifestyle changes can help the majority of patients, surgery is required for the most advanced stages. Several new treatments have been proposed with the aim of reducing patients'' postoperative pain, time to return to normal life, risk of early and late complications, and recurrence rate. Milligan-Morgan haemorrhoidectomy is considered to be the gold-standard approach for grade IV haemorrhoids. An increasing number of minimally invasive treatment options, including PPH and TST, have now been proposed for the management of grade III haemorrhoids. These approaches aimto correct the underlying pathophysiological mechanisms involved in the aetiology of haemorrhoids. An increased risk of recurrence is the price to pay for these minimally invasive and less painful treatments. With the improvement of operation mode and operation technology, the effect of surgical treatment of hemorrhoids has made considerable progress. This paper aims to sumup the new surgical methods of hemorrhoids so as to provide a reference to clinical treatment.