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邵书先,杨关根.内镜下狭窄切开术治疗混合痔PPH术后吻合口重度狭窄的临床疗效分析[J].浙江中西医结合杂志,2021,31(6):
内镜下狭窄切开术治疗混合痔PPH术后吻合口重度狭窄的临床疗效分析
Endoscopic stenostomy for the treatment of severe stenosis of anastomosis after mixed hemorrhoids PPH
投稿时间:2020-07-08  修订日期:2021-05-07
DOI:
中文关键词:  内镜  狭窄切开术  吻合口狭窄
英文关键词:Endoscopy  Stenostomy  Anastomotic stenosis
基金项目:浙江省基础公益研究计划项目(LGF20H270001)
作者单位E-mail
邵书先 杭州市第三人民医院 ssx021@126.com 
杨关根 杭州市第三人民医院 yangguangen88@126.com 
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中文摘要:
      目的:分析内镜下狭窄切开术治疗混合痔PPH术后吻合口重度狭窄的临床疗效;方法:回顾性分析2017年01月至2019年01月期间杭州市第三人民医院肛肠科收治PPH术后吻合口重度狭窄患者分别行内镜下狭窄切开术(治疗组)、扩肛术(对照1组)及纵切横缝术(对照2组)的临床资料,每组36例,对比三组患者术后临床有效率、术中情况、住院时间及费用、生活质量评分、直肠静息压变化、术后并发症、术后3月、6月手术满意度、控便能力及术后复发情况。结果:术后1月、3月、6月临床有效率,治疗组与对照1组相比较差异有统计学意义,与对照2组差异无统计学意义,但治疗组治愈率高于对照2组。三组术中出血、手术时间、住院时间及费用、术后后生活质量评分、直肠静息压、术后并发症、术后3月、6月手术满意度、术后3月、6月、12月随访复发情况差异具有统计学意义(P<0.05),三组肛门控便能力差异无统计学意义(P>0.05)。结论:内镜下狭窄切开术治疗PPH术后吻合口重度狭窄疗效显著,有很好的临床应用价值。
英文摘要:
      Objective Analyze the clinical effect of endoscopic stenostomy for severe anastomotic stricture after mixed hemorrhoids PPH; Methods Retrospective analysis of patients with severe anastomotic stricture after anastomotic surgery after PPH admitted to the Anorectal Department of Hangzhou Third People's Hospital from January 2017 to January 2019, respectively, underwent endoscopic stenostomy (treatment group) and anal expansion (control 1) Group) and longitudinal slit suture (control group 2) clinical data, 36 cases in each group, comparing the clinical effectiveness, intraoperative conditions, hospitalization time and cost, quality of life score, rectal resting pressure changes of the three groups of patients , Postoperative complications, surgical satisfaction at 3 and 6 months after surgery, ability to control stool and postoperative recurrence;Results The clinical effectiveness was 1 month, 3 months, and 6 months after operation. The difference between the treatment group and the control group 1 was statistically significant, but there was no significant difference from the control group 2, but the cure rate of the treatment group was higher than that of the control group 2. Three groups of intraoperative bleeding, operation time, hospitalization time and cost, postoperative quality of life score, rectal resting pressure, postoperative complications, postoperative satisfaction in 3 months and 6 months, postoperative satisfaction in 3 months and 6 months, The difference in recurrence at 12-month follow-up was statistically significant (P<0.05), and there was no statistically significant difference in the ability of anal stool control among the three groups (P>0.05);Conclusion Endoscopic stenostomy for the treatment of severe anastomotic stenosis after PPH has obvious curative effect, and has good clinical application value.
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