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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、术中下腹部疼痛、切除育肠黏膜宽度、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真肠黏膜宽度、完整度、痔核冋缩明显优于改进前（P<0.05），手术时间、术屮下腹疼痛、术屮出血、术后疼痛、术后出血、住院时间无显著性差异（P>0.05）；对于IV痔，双荷包缝合切除岚肠黏膜宽度、黏膜环完
2、整度、痔核冋缩明显优于单荷包纟H.（PvO.05）,但术屮岀血、术屮下腹部疼痛、术后肛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齐有利弊。对于III度痔,取用单荷包缝合已达到治疗目的，但需拿握荷包缝合技巧。而对于IV度痔或合并育肠黏膜脱垂者，取用双荷包缝合更合适。【关键词】内痔;PPH;荷包缝合Clinialinvestigationofthepursestringsuturetechniqueinprocedureforprolapseandhemo
3、rrhoids(reportof183cases)LiaoJiannan,QiuLei,XiePeibiao,etal.DepartmentofColoproctology,FoshanSecondpeople'sHospital,Foshan528000,Guangdong，China[Abstract]ObjectiveToinvestigateamoreidealtechniqueofpursestringsutureinprocedureforprolapseandhemorrhoids(PP
4、H).MethodsAtotalof183casesofIIIandIVdegreeprolapsedhemorrhoidsweretreatedbyPPH.GroupAwaswithimprovedpursestringsutureandgroupBwithunimprovedpursestringsuture・ResultsForIIIdegreehemorrhoid,theindexesofwidthofexcisedrectummucosalring,thecorrectionofprolap
5、osedhemorrhoidingroupAweresignificantlysuperiortothatingroupB,whiletheoperationtime,intraoperativeabdominalpain,intraoperativebleeding,postoperativeanalpain,postoperativeanalbleedingandhospitalstayshowednosignificantdifferencesbetweentwogroups(P>0.05).F
6、orIVdegreehemorrhoid,comparedwithgroupB,theindexesofthewidthofexcisedmucosalringandthecorrectionoftheprolapsedhemorrhoidrateweresignificantlysuperioringroupA(P<0.05),butmoreintraoperativebleeding,moreincideneeoflowerabdominalpainandpostoperativeanalpain
7、,IongeroperationtimewerefoundingroupA(P<0.05)・ConelusionForIIIdegreehemorrhoid,singlepursestringsuturecanreachtheaimoftreatment,butpursestringsuturetechniqueshouldbemastered・ForIVdegreehemorrhoidorprolapseofrectummucosal,doublepursestringsuturearemoresu
8、itable・[Keywords]Internalhemorrhoid;Procedureforprolapseandhemorrhoids;PursestringsuturePPH（procedureforprolapseandhemorrhoids）是近年来治疗痔病的重要进展之一。PPH虽然有诸多优点，但也有较多不足之处，如术屮吻合口出血、下腹部疼痛，术后出血、肛门不适、残留皮赘或痔核脱垂。其原因与黏膜下荷包缝合有关。我院2006年1月至2006年1
