陈恩++方远明

[摘要] 目的 探讨日间手术模式治疗混合痔患者的临床效果。 方法 统计分析我院普外一科肛肠组2014年6月～2015年6月开展的100例混合痔日间手术患者的临床资料。 结果 本组患者中95例手术当日出院，4例术后第1天出院，1例术后第5天出院，近期治愈率为100%。患者术后随访1年，复发率为0%。 结论 日间手术模式治疗混合痔患者安全可行，其住院时间短，加快床位周转，提高床位使用率，降低医疗费用，节省医疗资源，有助于患者身心健康，值得临床进一步应用。

[关键词] 混合痔；痔上黏膜环切术；日间手术；临床观察

[中图分类号] R657.18 [文献标识码] B [文章编号] 1673-9701（2017）03-0037-03

Clinical observation of 100 cases of daytime surgery of mixed hemorrhoids

CHEN En FANG Yuanming

No.1 Department of General Surgery， Ganzhou Peoples Hospital in Jiangxi Province， Ganzhou 341000， China

[Abstract] Objective To explore the clinical effect of daytime surgery in the treatment of mixed hemorrhoids. Methods The clinical data of 100 patients receiving daytime surgery of mixed hemorrhoid in the No.1 Department of General Surgery in our hospital from June 2014 to June 2015 were analyzed statistically. Results A total of 95 patients in this group were discharged on the same day， 4 patients were discharged on the first day after surgery， and 1 patient was discharged on the fifth day after surgery. The recent cure rate was 100%. The follow-up period was 1 year after the surgery and the recurrence rate was 0%. Conclusion It is safe and feasible for the daytime surgery in the treatment of mixed hemorrhoids. Daytime surgical model is in line with biological-psychological-social medical model requirements， so that patients are able to return to the family as soon as possible and merge into the society. The model can contribute to the physical and mental health of patients. The daytime surgical model of mixed hemorrhoids， due to its short hospital stay， can speed up bed turnover， improve bed utilization， reduce medical costs， and save medical resources， which is worthy of further clinical application.

[Key words] Mixed hemmorhage； Procedure for prolapse and hemorrhoids； Daytime surgery； Clinical observation

混合痔是肛腸科中的常见病、多发病，临床表现为大便带血、滴血、射血及肛门肿痛、痔核外露等，保守治疗大都只能缓解症状，手术是目前最彻底的治疗手段。其中吻合器痔上黏膜环切术（PPH）因其恢复快、痛苦小等特点，一经引入就在我国迅速开展；主要适用于Ⅲ、Ⅳ期内痔，环状混合痔和直肠内脱垂[1]。2014年日间手术年会国内专家提出了日间手术的概念：以前需要住院多日进行的手术，现在在1个工作日内完成治疗。2014年6月～2015年6月我院普外一科肛肠组将吻合器痔上黏膜环切术结合日间手术模式用于100例混合痔患者的治疗，效果满意，现报道如下。

1 临床资料

1.1 一般资料

本组100例患者均诊断为混合痔。其中男54例，女46例。年龄22～60岁，平均41岁。病程1～20余年不等。临床表现均为：大便带血、滴血或射血，肛门肿痛，痔核外露，肛门镜下齿状线上下均可见痔黏膜隆起，痔核环行隆起并脱出肛外。……