葛春超

【摘要】 目的 探讨内痔注射术加外剥内扎术治疗环状混合痔的疗效。方法 265例环状混合痔患者， 均采用内痔注射术加外剥内扎术进行治疗， 观察治疗效果。结果 265例患者中， 治愈260例（98.1%）， 5例术后2个月仍有轻度便血。平均手术时间（20±12）min， 术后平均疼痛指数为4.2分， 疼痛均在能够忍受的范围内， 平均住院天数（7.6±2.8）d， 平均切口愈合时间（20±8）d。术后肛门狭窄6例， 经扩肛后不适症状消失；术后肛缘水肿31例， 经局部高渗盐水贴敷等对症治疗均能消退；术后尿潴留26例， 其中23例經过对症理疗后均可自行排尿， 3例注射新斯的明无效后， 给予留置导尿。结论 内痔注射术加外剥内扎术是一种治疗环状混合痔安全有效的方法。

【关键词】 环状混合痔；内痔注射术；外剥内扎术；疗效

DOI：10.14163/j.cnki.11-5547/r.2017.01.028

Effect analysis of injection therapy of internal hemorrhoids and external dissection and internal ligation therapy in the treatment of circular mixed hemorrhoids GE Chun-chao. Department of anorectal， Liaoning Province Shenyang City Dongyao Hospital， Shenyang 110126， China

【Abstract】 Objective To explore curative effect of injection therapy of internal hemorrhoids and external dissection and internal ligation therapy in the treatment of circular mixed hemorrhoids. Methods A total of 265 circular mixed hemorrhoids patients received injection therapy of internal hemorrhoids and external dissection and internal ligation therapy for treatment， and their treatment effect was observed. Results Among 265 patients， there were 260 cured cases （98.1%）， 5 patients had mild bloody in 2 months postoperation， with mean operation time as （20±12）min， postoperative average pain index as 4.2 points. All patients had pain within the scope of tolerance， with mean hospital stay time as （7.6±2.8）d， mean incision healing time as （20±8）d. There were 6 stricture of anus cases after operation， and uncomfortable symptoms disappeared after expanding anus. There were 31 around anus edema cases after operation， and it disappeared after receiving local hypertonic saline. There were 26 postoperative uroschesis cases， in which 23 cases could voluntarily urinate after symptomatic therapy， and 3 cases received retention catheterization after invalid injection of neostigmine. Conclusion Combination of injection therapy of internal hemorrhoids and external dissection and internal ligation therapy is a secure and effective method for the treatment of circular mixed hemorrhoids.

【Key words】 Circular mixed hemorrhoids； Injection therapy of internal hemorrhoids； External dissection and internal ligation therapy； Curative effect

本院肛肠科2010～2015年采用内痔注射术加外剥内扎术治疗环状混合痔患者265例， 收到满意效果， 现报告如下。

1 资料与方法

1. 1 一般资料 选取本院肛肠科2010～2015年收治的环状混合痔患者265例， 其中男156例， 女109例；年龄18～74岁， 平均年龄37岁；病程1.5～20.0年， 平均病程12.4年。患者均有不同程度的肛门肿物脱出及便血。其中76例肿物脱出嵌顿， 表现为局部水肿、血栓形成。

1. 2 治疗方法 患者均完善常规术前检查， 排除手术禁忌证， 术前30 min给予地西泮片1片口服， 预防麻醉药物毒性反应。麻醉采取骶管麻醉或局部浸润麻醉， 麻醉成功后， 患者取侧卧位或截石位进行手术， 常规消毒铺巾， 肛管内反复消毒， 在麻醉状态下进行再次指诊排除手术禁忌证。置入肛门镜， 检查……