吻合器痔上黏膜环形切除术联合外剥内扎术治疗重度痔疮的效果OA

Objective:To investigate the effect of procedure for prolapse and hemorrhoidals(PPH)combined with Milligan-Morgan(M-M)haemorrhoidectomy in the treatment of severe hemorrhoids.Method:The medical records of 106 patients with severe hemorrhoids who admitted to Xiamen Chang Gung Hospital Affiliated to Huaqiao University from September 2022 to September 2023 were retrospectively collected,they were divided into the experimental group(receiving PPH combined with M-M treatment,n=53)and the control group(receiving M-M treatment,n=53)according to different surgical procedures.The surgical indexes,anorectal dynamics indexes,pain scores,pain stress factors and complications were compared between two groups.Result:The intraoperative blood loss in the experimental group was less than that in the control group,and the wound healing time,operation time and hospitalization time were shorter than those in the control group,and the differences were statistically significant(P<0.05);at 1 month after operation,the maximum anal systolic pressure(MASP)and anal resting pressure(ARP)of two groups were lower than those before operation,and those in the experimental group were lower than those in the control group,the differences were statistically significant(P<0.05);at 1 d after operation,the levels of serum prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT)and substance P(SP)in two groups were higher than those before operation,but those in the experimental group were lower than those in the control group,the differences were statistically significant(P<0.05);the incidence of complications in the experimental group was 1.89%(1/53),which was lower than 15.09%(8/53)in the control group,and the difference was statistically significant(P<0.05).Conclusion:Compared with M-M alone,PPH combined with M-M in the treatment of severe hemorrhoids can further optimize surgical indexes,alleviate pain,improve anorectal dynamics,reduce the risk of complications,and have less impact on the level of pain stress factors.