超声刀联合治疗重度环形混合痔临床观察.docVIP

超声刀联合治疗重度环形混合痔临床观察【摘要】 目的 探讨用超声刀联合治疗重度环形混合痔的临床应用价值。方法 将206例重度环形混合痔患者分为两组,治疗组102例,使用超声刀联合疗法;对照组104例,采用传统外剥内扎治疗。结果 经临床观察,超声刀联合疗法具有手术时间短、术中出血少、创口小,疼痛轻,愈合快,并发症少等优点。结论 超声刀联合疗法疗效明显优于传统外剥内扎术。 【关键词】重度环形混合痔;超声刀;联合; 临床观察 The Clinic Observation on the Treatment for the Serious Annular Hemorrhoid Making Use of Ultrasonic Operation Knife WANG Yue hui,YU Zhi tao,LI Xue hua,et al.The Anal and Intestinal Department of the People’s Hospital of Meizhou,Guangdong,514031 China 【Abstract】 Objective To inquiring into the clinic applicative value to treat the serious annular hemorrhoid making use of ultrasonic operation knife.Methods We divided 206 cases into two groups,102 of whom were to be treated by the ultrasonic operation knife,104 of whom were to be treated by the traditional treatment that the outer parts were stripped and the inner parts are bund.Results After clinic observation,the group which was treated by ultrasonic operation knife has the following advantages,shorter operational time,less bleeding in the operation,smaller operational wound,mild pain,faster heal and less complications.Conclusion Obviously,the mixed treatment making us of ultrasonic operation knife has more advantages than the traditional treatment that the outer parts are stripped and the inner parts are bund. 【Key words】 Serious annular hemorrhoid; Ultrasonic operation knife; Mixed; Clinic observation 重度环形混合痔是肛肠外科的难点。传统的外剥内扎术具有疗程长、术后疼痛剧烈、术后易狭窄等的缺陷。笔者因此使用超声刀联合疗法治疗重度环形混合痔,取得了满意的疗效,并与传统的外剥内扎术作出全面的比较分析。 1资料与方法 1.1 一般资料 研究对象为2004~2009年间在本科收住的206例重度环形混合痔患者,男108例,女98例,年龄40 79岁,平均(54.5±4.2)岁,病史5~20年。超声刀联合疗法组102例,男68例,女34例,平均年龄52.2±4.87岁。外剥内扎术组104例,男54例,女50例,平均年龄(57±6.47)岁。两组一般资料比较无显著差异。 1.2 治疗方法 1.2.1 超声刀联合疗法组 患者取左侧卧位,常规消毒和骶麻。①肛镜下取消痔灵生理盐水1:1注射液按常规四步注射,注射完毕后用手指按摩局部使药液均匀分布;②对环形混合痔进行分段设计,用皮钳提起痔核,远端用剪刀做一V形切口切开皮肤,用超声刀切割剥离至齿线上约0.5 cm处,用中弯血管钳钳夹内痔基底部及痔上黏膜,用大圆针带8号丝线于痔核上0.3~0.5 cm处进针结扎,然后纵行向下贯穿在弯血管钳下缘出针8字缝扎痔核基底,使其产生向上的悬吊效果。注意不要让结扎点处在同一平面,以防形成狭窄环。如在两个较大痔核间还遗留了隆起较甚的皮桥,则可以在肛门皮肤处作切断搭桥术。 1.2.2 外