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1、PPH手术荷包缝合技术的临床探讨(附183例报告)摘要】目的探讨适合PPH手术的荷包缝合技术。方法对183例III、IV度环状脱垂性内痔行PPH术，比较分析手术时间、术屮下腹部疼痛、切除宜肠黏膜宽度、吻合口部位、术屮出血、痔核冋缩、术示肛门疼痛、术示出血及住院时间。结果对于III度痔，改进荷包缝合后切除总肠黏膜宽度、完整度、痔核回缩明显优于改进而(P<0.05)，手术时间、术中卜應疼痛、术中出血、术后疼痛、术后出血、住院吋间无显著性差异(P>0.05)；对于IV痔，双荷包缝合切除总肠黏膜宽度、黏膜环完整度、痔核回缩明显优于单荷包组(PvO.05),但术中出血、术中下腹部疼痛、术后肛
2、门疼痛明显多于单荷包组，手术时间明显长于单荷包组(PvO.05)。结论双荷包缝合与单荷包缝合各有利弊。对于III度痔，取用单荷包缝合己达到治疗目的，但需寧握荷包缝合技巧。而对于IV度痔或合并总肠黏膜脱垂者，取用双荷包缝合更合适。【关键词】内痔;PPH;荷包缝合Clinialinvestigationofthepursestringsuturetechniqueinprocedureforprolapseandhemorrhoids(reportof183cases)LiaoJiannan,QiuLei,XiePeibiao,etal.DepartmentofColoproctolo
3、gy,FoshanSecondpeople'sHospital,Foshan528000,Guangdong,China[Abstract]ObjectiveToinvestigateamoreidealtechniqueofpursestringsutureinprocedureforprolapseandhemorrhoids(PPH).MethodsAtotalof183casesofIIIandIVdegreeprolapsedhemorrhoidsweretreatedbyPPH.GroupAwaswithimprovedpursestringsutureandgroup
4、Bwithunimprovedpursestringsuture・ResultsForIIIdegreehemorrhoid,theindexesofwidthofexcisedrectummucosalring,thecorrectionofprolaposedhemorrhoidingroupAweresignificantlysuperiortothatingroupB,whiletheoperationtime,intraoperativeabdominalpain,intraoperativebleeding,postoperativeanalpain,postopera
5、tiveanalbleedingandhospitalstayshowednosignificantdifferencesbetweentwogroups(P>0.05).ForIVdegreehemorrhoid,comparedwithgroupB,theindexesofthewidthofexcisedmucosalringandthecorrectionoftheprolapsedhemorrhoidrateweresignificantlysuperioringroupA(P<0.05),butmoreintraoperativebleeding,moreinciden
6、ceoflowerabdominalpainandpostoperativeanalpain,IongeroperationtimewerefoundingroupA(P<0.05).ConelusionForIIIdegreehemorrhoid,singlepursestringsuturecanreachtheaimoftreatment,butpursestringsuturetechniqueshouldbemastered.ForIVdegreehemorrhoidorprolapseofrectummucosal,doublepursestringsuturearem
7、oresuitable・[Keywords]Internalhemorrhoid;Procedureforprolapseandhemorrhoids;PursestringsuturePPH(procedureforprolapseandhemorrhoids)是近年来治疗痔病的重耍进展Z—。PPH虽然有诸多优点，但也有较多不足Z处，如术中吻合口出血、下腹部疼痛，术后出血、肛门不适、残帘皮赘或痔核脱垂。其原因与黏膜下荷包缝合有关。我院2006年1月至2006年12刀
