刘晓彬　郭文涛　曾智辉

[摘要]目的 研究改良外剥内扎术联合侧方内括约肌部分切断术治疗环状混合痔的临床效果。方法 将2015年1月～2016年12月在我院接受治疗的80例环状混合痔患者按照随机数字法分为两组，每组40例。对照组患者采用改良外剥内扎术治疗，研究组给予改良外剥内扎术联合侧方内括约肌部分切断术治疗。观察并对比两组患者的疼痛评分、创面水肿程度、创面愈合时间及并发症发生率。结果 研究组术后疼痛评分显著低于对照组（P<0.05）。研究组患者创面水肿程度较对照组显著要轻（P<0.05）。研究组患者创面愈合时间[（12.54±2.64）d）]显著短于对照组]（17.09±5.47） d] （P<0.05）。研究组的并发症发生率（5.0%）显著低于对照组（32.5%）（P<0.05）。结论 给予环状混合痔患者改良外剥内扎术联合侧方内括约肌部分切断术治疗，可显著减轻患者疼痛程度，缩短创面愈合时间，减轻患者创面水肿程度，降低并发症发生率，能够对患者的康复更有帮助。

[关键词]改良外剥内扎术；侧方内括约肌部分切断术；环状混合痔

[中图分类号] 657.1+8 [文献标识码] A [文章编号] 1674-4721（2017）05（a）-0035-03

[Abstract]Objective To research the clinical effect of improved milligan morgan hemorrhoidectomy combined with partial internal sphincterotomy in treatment of circumferential mixed hemorrhoids.Methods 80 patients with circumferential mixed hemorrhoids treated in our hospital from January 2015 to December 2016 were randomly divided into 2 groups according to the random number method，40 patients were treated with improved milligan morgan hemorrhoidectomy （the control group），40 patients were treated with improved milligan morgan hemorrhoidectomy combined with partial internal sphincterotomy （the study group）.The pain score，wound edema degree，wound healing time and incidence rate of complications were observed and compared between the two groups.Results The postoperative pain score of the study group was significantly lower than that of the control group （P<0.05）.Wound edema degree in the study group were significantly lighter than that in the control group （P<0.05）.The wound healing time [（12.54±2.64） d] in the study group was significantly shorter than that in the control group [（17.09±5.47） d] （P<0.05）.The incidence rate of complications in the study group （5.0%） was significantly lower than that in the control group （32.5%） （P<0.05）.Conclusion Improved milligan morgan hemorrhoidectomy combined with partial internal sphincterotomy in treatment of circumferential mixed hemorrhoids can significantly reduce pain degree of patients，shorten wound healing time，reduce wound edema，reduce the incidence rate of complications，can help more patients on the rehabilitation.

[Key words]Improved milligan morgan hemorrhoidectomy；Partial internal sphincterotomy；Circumferential mixed hemorrhoids

內痔相应部位的外痔血管融合形成混合痔[1]。混合痔患者临床症状包括外痔和内痔的症状，严重的症状表现为环状痔脱出，这种症状称之为环状混合痔。环状混合痔对患者生活质量产生严重影响，治疗困难，因此环状混合痔为肛肠科的一种难治病[2]。目前手术为主要治疗方式。常用术式为外剥内扎术[3]。但该术式可引起患者出现多种并发症，例如肛缘水肿、肛门疼痛、肛门狭窄及尿潴留等。研究表明，侧方内括约肌切可减轻患者术后疼痛程度，缓解括约肌痉挛，减轻肛缘水肿，改善局部静脉及淋巴回流，防止患者术后出现并发症[4]。为寻求环状混合痔安全有效的治疗方式，现在对我院环状混合痔患者使用改良外剥内扎术联合侧方内括约肌部分切断术治疗情况进行分析，具体情况如下。

1资料与方法