The Curative Effect of Modified PPH on Circumferential Mixed Hemorrhoid of Connective Tissue Type and Its Influences on Serum HIF-1a VEGF and MMP-9 Levels
LIANG Jiadi, SU Jinhua, LI Xiaolan
Dongguan People's Hospital, Guangdong Dongguan 523000, China
Abstract:Objective: To explore curative effect of modified procedure for prolapse and hemorrhoids (PPH) on circumferential mixed hemorrhoid of connective tissue type and its influences on levels of serum hypoxia-inducible factor-1a (HIF-1a), vascular endothelial growth factor (VEGF) and matrix metalloproteinase 9 (MMP-9). Methods:The clinical data of 80 patients with circumferential mixed hemorrhoid of connective tissue type who were admitted to the hospital from September 2018 to June 2019 were retrospectively analyzed. According to different treatment methods, they were divided into control group (n=40) and observation group (n=40).The control group was treated with traditional Milligan-Morgan, while observation group was treated with modified PPH. The perioperative indexes, clinical curative effect, score of visual analogue scale (VAS), levels of serum HIF-1a, VEGF and MMP-9, incidence of complications and anal function score were compared between the two groups. Results:The operation time, hospitalization time and wound healing time in observation group were shorter than those in control group, and intraoperative blood loss was less than that in control group (P<0.05). The total response rate in observation group was higher than that in control group (95.00% VS 77.50%) (P<0.05). After treatment, VAS scores in observation group were lower than those in control group(P<0.05). After treatment, levels of serum HIF-1a, VEGFand MMP-9 in observation group were lower than those in control group(P<0.05). The incidence of complications in observation group was lower than that in control group (7.50% VS 30.00%) (P<0.05). The anal function score in observation group was lower than that in control group (P<0.05). Conclusion:The curative effect of modified PPH is significant on circumferential mixed hemorrhoid of connective tissue type, which can alleviate pain, reduce levels of serum HIF-1a, VEGF and MMP-9, improve anal function, with high safety.
梁嘉迪, 苏锦华, 李晓兰. 改良PPH治疗结缔组织型环状混合痔疗效及对血清HIF-1a VEGF和MMP-9水平的影响[J]. 河北医学, 2020, 26(6): 994-997.
LIANG Jiadi, SU Jinhua, LI Xiaolan. The Curative Effect of Modified PPH on Circumferential Mixed Hemorrhoid of Connective Tissue Type and Its Influences on Serum HIF-1a VEGF and MMP-9 Levels. HeBei Med, 2020, 26(6): 994-997.
[1] 马志才,王建设,戴炜炜,等.分段外剥内扎加皮桥结扎整形术治疗环状混合痔的临床观察[J].中国医师进修杂志,2016,39(12):1095~1098. [2] Yong-Heng He,Zhi-Jun Tang,Xiang-Tong Xu,et al.Treatment of mixed hemorrhoids by RPH with the simplified milligan-morgan surgery:a multi-center,randomized,controlled clinical trial[J].Chinese Journal of Integrated Traditional & Western Medicine,2017,37(4):422~425. [3] Xu L,Chen H,Lin G,et al.Transanal hemorrhoidal dearterialization with mucopexy versus open hemorrhoidectomy in the treatment of hemorrhoids:a meta-analysis of randomized control trials[J].2018,20(12):1~9. [4] 薛雾松,刘薇,余文,等.吻合器痔上黏膜环切术与外剥内扎术治疗混合痔的疗效比较[J].贵州医药,2018,42(6).123~125. [5] 吴在德.外科学[M].人民卫生出版社,2005.148. [6] 田志勇,毕旭平.单纯PPH与PPH联合外痔切剥术治疗混合痔的临床疗效比较[J].中国现代普通外科进展,2016,19(8):651~653. [7] Xu L,Chen H,Lin G,et al.Transanal hemorrhoidal dearterialization with mucopexy versus open hemorrhoidectomy in the treatment of hemorrhoids:a meta-analysis of randomized control trials[J].2018,20(12):1~9. [8] 宋新飞.PPH术与外剥内扎术治疗环形混合痔102例对比研究[J].陕西医学杂志,2015,44(9):1222~1224. [9] 蓝兴菊.环状混合痔行吻合器痔上黏膜环切钉合术患者的近期及远期并发症分析[J].重庆医学,2015,17(1):110~112.