覃安强

[摘要] 目的 评价PPH加外剥内扎术配合消痔灵注射液治疗环状混合痔的疗效。 方法 回顾性分析该院2012年3月—2014年12月PPH加外剥内扎术配合消痔灵注射液治疗环状混合痔患者的临床资料。 结果 患者手术时间为25～40 min，平均手术时间为29.5 min；术后住院时间平均为9.3 d；所有患者均治愈，术后随访1～12个月，术后出血2例（1.5%），残留皮赘9例（7.1%），因无不适症状而随访观察，患者均无肛门水肿、肛门失禁、肛门狭窄、术后大出血、感染、肛门坠胀等并发症的发生。结论 PPH加外剥内扎术配合消痔灵注射液治疗环状混合痔患者治愈率高，术后并发症少、恢复快，住院时间短，值得临床上推广与应用。

[关键词] PPH；外剥内扎术；环状混合痔

[中图分类号] R65 [文献标识码] A [文章编号] 1674-0742（2015）06（a）-0034-02

PPH Combined with Milligan-morgan Haemorrhoidectomy and Xiaozhiling Injection in Treatment of 126 Cases of Circumferential Mixed Hemorrhoid

QIN An-qiang

Department of Anus-intestines， Affiliated Hospital of Youjiang Medical University for Nationalities， Baise， Guangxi， 533000 China

[Abstract] Objective To evaluate the curative effect of PPH combined with Milligan-morgan haemorrhoidectomy and xiaozhiling injection in treatment of circumferential mixed hemorrhoid Methods Our department were retrospectively analyzed in March 2012 to December 2014 in PPH plus external strip of xiaozhi ling injection and pierced surgery for the treatment of the clinical data of patients with circumferential mixed hemorrhoid. Results The patients， operation time were 25-40 min， the average operation time was 29.5 min. Postoperative hospital stay with an average of 9.3 d； All patients were cured， 1-12 months follow-up， postoperative hemorrhage in 2 cases （1.5%）， the residual skin fat 9 cases （7.1%）， because there was no discomfort and follow-up， patients were no anal edema， anal incontinence， anal stenosis， postoperative complications such as bleeding， infection， anal the belly. Conclusion PPH plus external strip internal tied in with xiaozhi spirit injection in patients with circumferential mixed hemorrhoid cure rate was high， fewer postoperative complications， quicker recovery， shorter hospitalization time， worthy of clinical popularization and application.

[Key words] PPH； Milligan-morgan Haemorrhoidectomy； Circumferential mixed hemorrhoid

痔是如今临床肛肠科中非常常见的病症之一，伴随着近年来社会上人群生活节奏及饮食结构的巨大变化，该症的发病率呈现逐年增高的趋势。混合痔是指痔位于齿状线上下，表面同时为直肠粘膜以及肛管皮肤所覆盖，混合痔围绕直肠肛管一周就称之为环状混合痔，该疾病病情比较严重，主要表现为疼痛、瘙痒、便血以及痔块脱垂，影响患者正常生活，为肛肠科难治疾病之一[1]。1975年有学者提出了肛垫下移学说，认为肛垫为人体正常的解剖结构，具有精细的排便功能，肛垫的下移和病理性肥大，会导致痔疮的发生[2]。吻合器痔上粘膜环切术（procedure for prolapse and hemorrhoids，PPH），又称为吻合器痔切除术、肛垫悬吊术，是1993年由意大利外科医师Longo设计的一种通过吻合器环形切除吻合直肠下端粘膜来治疗混合痔的手术方法，手术的理论基础就是“肛垫下移学说”[3]。……