Abstract：Objective: To analyze the application value of anal restitution combined with modified external dissection and internal ligation in multiple mixed hemorrhoids. Methods: A total of 112 patients with multiple mixed hemorrhoids undergoing surgical treatment in the hospital were retrospectively enrolled between June 2020 and March 2023. According to different surgical methods, they were divided into modified group (modified external dissection and internal ligation, n=47) and combination group (anal restitution on basis of modified group, n=65). The perioperative indexes were compared between the two groups. The curative effect and postoperative anal pain in the two groups were evaluated. The anal smoothness, edema of anal margin and hemafecia were compared before and after surgery, and the occurrence of complications was recorded. Results: The hospitalization time in combination group was shorter than that in modified group (P<0.05). The total number of effective cases in combination group was more than that in modified group (P<0.05). With time, VAS scores were gradually decreased in both group. At 1d, 3d and 5d after surgery, VAS scores in combination group were lower than those in modified group (P<0.05). At 3d after surgery, scores of anal smoothness, anal margin edema and hemafecia in combination group were lower than those in modified group, and difference values were greater than those in improved group (P<0.05). Compared with the modified group, the combination group had a lower complication rate(P<0.05). Conclusion: The curative effect of anal restitution combined with modified external dissection and internal ligation is good on multiple mixed hemorrhoids, which can relieve postoperative pain, improve anal smoothness and anal margin edema, reduce the occurrence of hemafecia and complications.
陈旭渊, 罗仕云, 李文忠, 李毅, 何家杰. 肛门整复术联合改良外剥内扎术治疗多发性混合痔的应用价值分析[J]. 河北医学, 2024, 30(4): 674-678.
CHEN Xuyuan, LUO Shiyun, LI Wenzhong, et al. Application Value of Anal Restitution Combined with Modified External Dissection and Internal Ligation in the Treatment of Multiple Mixed Hemorrhoids. HeBei Med, 2024, 30(4): 674-678.
[1] Lu B,Du J,Wu X.The effects of modified Buzhong Yiqi decoction combined with Gangtai ointment on the wound healing and anal function in circumferential mixed hemorrhoid patients[J].Am Transl Res,2021,13(7):8294-8301. [2] 周丽,王奎,邹鲜容.改良外剥内扎术联合中药治疗老年混合痔[J].中国中西医结合外科杂志,2018,24(5):537-540. [3] Luo S,Zhang X,Hou Y,et al.Transanal and transabdominal combined endoscopic resection of rectal stenosis and anal reconstruction based on transanal endoscopic technique[J].Surg Endosc,2021,35(12):6827-6835. [4] 中华医学会外科学分会结直肠肛门外科学组,中华中医药学会肛肠病专业委员会,中国中西医结合学会结直肠肛门病专业委员会.痔临床诊治指南(2006版)[J].中华胃肠外科杂志,2006,9(5):461-463. [5] 中华人民共和国中医药行业标准.中医肛肠科病证诊断疗效标准[M].南京:南京大学出版社,1994:131-132. [6] Sung YT,Wu JS.The visual analogue scale for rating,ranking and paired-comparison (VAS-RRP):a new technique for psychological measurement[J].Behav Res Methods,2018,50(4):1694-1715. [7] 姚健,唐学贵,黄德铨,等.改良外剥内扎术联合注射悬吊肛门整复术治疗多发性混合痔临床疗效分析[J].西部医学,2013,25(1):103-106. [8] Du B,Xu Z,Zhong X.Electroacupuncture for postoperative pain in mixed hemorrhoids:a meta-analysis[J].Medicine (Baltimore),2022,101(50):e32247. [9] Du P,Wang SY,Zheng PF,et al.Comparison of overall survival and quality of life between patients undergoing anal reconstruction and patients undergoing traditional lower abdominal stoma after radical resection[J].Clin Transl Oncol,2019,21(10):1390-1397. [10] 杭春平.外切内扎术基础上予以肛门微整形联合括约肌侧切术治疗环状混合痔的临床疗效观察[J].结直肠肛门外科,2018,24(6):586-590. [11] Huang H,Gu Y,Ji L,et al.A new mixed surgical treatment for grades Iii and Iv hemorrhoids:modified selective hemorrhoidectomy combined with complete anal epithelial retention[J].Arq Bras Cir Dig,2021,34(2):e1594.
2024, Vol. 30 
冀公网安备13080202000677号