PPH术与Milligan-Morgan术治疗环状痔的临床效果对照分析

摘要

Objective To investigate the effectiveness of patients with circumferential hemorrhoids treated with PPH and Milligan-Morgan technique.Methods 100 cases with circumferential hemorrhoids from January 2013 to January 2016 were randomly assigned to procedures for prolapse and haemorrhoids (PPH) (the observation group,50 patients) and Milligan-Morgan procedures (the control group,50 patients).The efficacy,complications and follow-up of the two groups were observed.Results Compared with the pre-operation,the postoperative self-reported symptom questionnaire of bleeding,pain,prolapse and total scores in both the two groups turned lower,and the difference was statistically significant (P ＜ 0.05).The postoperative self-reported symptom questionnaire of pain in observation group was lower than the control group (t =6.982,P ＜ 0.05),while the scores of bleeding,prolapse and total one had no difference between the two groups (t =0.904,0.953,0.893,P ＞ 0.05).Compared with the control group,the complication rate of pain,abdominal discomfort,anal pendant expansion in the observation group and the control groups were 8％VS 42％,14％ VS 0,and 24％ VS 8％ respectively,and the difference was statistically significant (x2 =6.212,7.231,7.194,P ＜ 0.05).And the rate of edema,urinary retention,recurrence and postoperative hemorrhage had not statistically difference (x2 =0.948,0.942,0.924,0.894,P ＞ 0.05).Conclusion PPH surgical treatment of hemorrhoids is a new technology with good effect and high economic cost,which requires more strict clinical indications.%目的 探讨PPH术与Milligan-Morgan术对环状痔的临床治疗效果. 方法 选择2013年1月至2016年1月期间我院收治的100例环状痔患者,将患者按照随机分组的方式分成观察组及对照组,每组各50例.观察组患者采用PPH术式治疗,对照组患者采用Milligan-Morgan术式治疗.观察两组患者的疗效、并发症及随访状况. 结果 与治疗前相比,两组患者在问卷调查中的便血、疼痛、脱出及总分方面差异有统计学意义(P＜0.05).观察组和对照组患者治疗后在便血、脱出及总分方面评分分别为(0.18±0.39)分VS(0.05 ±0.23)分,(0.41 ±0.58分)VS(0.16 ±0.39)分和(0.84 ±0.97)分VS(0.53±0.81)分,组间比较差异无统计学意义(t=0.904、0.953、0.893,P＞0.05),观察组疼痛症状评分为(0.24±0.42)分VS(0.31±0.53)分,差异有统计学意义(t=6.982,P＜0.05).观察组和对照组患者在疼痛、下腹不适、肛门坠胀的发生率分别为8％ VS 42％,14％ VS 0,和24％ VS 8％,差异有统计学意义(x2=6.212、7.231、7.194,P＜0.05);在水肿、尿潴留、术后复发、术后出血方面差异无统计学意义(x2 =0.948、0.942、0.924、0.894,P＞0.05). 结论 PPH手术方式是一种治疗痔的新技术,治疗效果良好,但是患者的经济负担较高,需要较为严格的临床适应证,仍需临床上深入研究.