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1、经肛门吻合器痔上黏膜环切术治疗III、IV度痔临床分析[摘要]目的:探讨经肛门吻合器痔上黏膜环切术治疗痔的临床运用价值和经验。方法:对230例III度、IV度痔采用经肛门吻合器痔上黏膜环切术患者的临床资料进行回顾性分析。结果:230例患者手术均成功,手术时间为10-15min,平均12.5min;住院时间及伤口愈合时间为2〜5d,平均3.5d;恢复工作时间为5~7d,平均6d;2个月内肛门有不适感28例;术后疼痛时间为6〜10h,平均8h;术后无肛门狭窄及大便失禁;术后Id尿潴留19例;术后1d内出血65例(纸染);术后随访6个月〜1年无复发,排便功能不受影响。经X线片检查,吻合钉术后2
2、个月开始排钉,大部分患者术后3~8个月吻合钉已排完,术后超过1年以上未排完者17例,最早1例3个月排完。结论:经肛门吻合器痔上黏膜环切术治疗III度、IV度痔是一种安全、有效的方法,具有操作简单、手术时间短、术后疼痛轻、缩短住院时间及患者恢复周期短等优点。[关键词]经肛门;吻合器;痔;临床分析[中图分类号]R657.1+8[文献标识码]B[文章编号]1674-4721(2012)01(a)-174-02ClinicalanalysisofhemorrhoidstaplerthroughtheanusmucosalresectiontreatmentofgradeIII,IVdegreeh
3、emorrhoidsLUOCong,LIJiajia,YUSongweiLiverandGallSurgicalDepartmentofthePeople'sHospitalinWenshanPrefecture,YunnanProvinee,Wenshan663000,China[Abstract]Objective:Toevaluatetheclinicalusingvalueandexperieneeofanalmucosalhemorrhoidstaplerresectioninthetreatmentofhemorrhoids.Methods:Twohundredandthir
4、tycasesofgradeIII,IVdegreehemorrhoidstaplerthroughtheanususingmucosalresectionpatients'clinicaldatawereretrospectivelyanalyzed・Results:230caseswereallwithsuccessfulsurgery,theoperativetimewere10-15minutes,anaverageof12.5minutes;hospitalstayandwoundhealingtimewere2-5days,anaverageof3.5days;recover
5、ytimewere5-7days,anaverageof6days;2monthsanaldiscomfortin28cases;postoperativepaintimewas6~10hours,anaverageof8hours;hadnopostoperativeanalstenosisandfecalincontinence;after1dayofurinaryretentionin19cases;after1dayofbleedingin65cases(dyedpaper);thepatientswerefollowedupfor6monthsto1yearwithoutrec
6、urrence,bowelfunctionwasnotaffected.TheX-rayexaminationweredone,consistentwithnailsafter2monthsofthebeginningrowofnails,themajorityofpatientsafter3-8monthsofconsistentnailhadbeendrained,17caseswerenotdrainedaftermorethanoneyear,onecasedrainedintheearliest3months・Conclusion:Hemorrhoidstaplerthroug
7、htheanusmucosalresectiontreatmentofgradeIII,IVdegreehemorrhoidsisasafeandeffectivemethod.Ithasmeritsuchassimpleoperation,shorteroperativetime,postoperativepain,shorterhospitalstayandrecoveryperiodsoon.[Keywords]Peranum