外剥内扎术联合吻合器痔上黏膜环切术治疗环状混合痔患者的疗效及其对肛门功能的影响

临床普外科电子杂志 ›› 2025, Vol. 13 ›› Issue (2): 81-.

外剥内扎术联合吻合器痔上黏膜环切术治疗环状混合痔患者的疗效及其对肛门功能的影响

密山市中医医院普外科，黑龙江密山 158300

出版日期:2025-04-01 发布日期:2025-08-11

The therapeutic effect of external stripping and internal ligation combined with stapler hemorrhoidectomy on patients with mixed hemorrhoids and its impact on anal function

General Surgery Department of Mishan Traditional Chinese Medicine Hospital, Heilongjiang Mishan 158300, China

Online:2025-04-01 Published:2025-08-11

摘要/Abstract

摘要：

目的研究外剥内扎术联合吻合器痔上黏膜环切术治疗环状混合痔患者的效果及其对肛门功能的影响。方法选择 2023 年 1 月至 12 月密山市中医医院收治的 60 例环状混合痔患者，按照随机数字表法分为两组。对照组（n=30）实施外剥内扎术治疗，观察组（n=30）在对照组基础上，联合吻合器痔上黏膜环切术治疗，比较两组患者临床疗效和复发情况、手术指标、术后并发症发生情况，术后疼痛及肛门功能恢复情况，术后不同时间下肛肠动力学指标。结果观察组临床总有效率高于对照组，1 年内复发率低于对照组，且术后视觉模拟评分法评分、Williams 标准评级均低于对照组，差异均有显著性（P ＜ 0.05）。观察组患者的手术时间、住院时间、创面愈合时间均短于对照组，术中出血量少于对照组，差异均有显著性（P ＜ 0.001）。术后 1 个月，两组肛肠动力学指标无显著差异（P ＞ 0.05）；术后 3 个月，两组肛肠动力学指标均较术后 1 个月有所改善，且观察组各项指标均优于对照组，差异均有显著性（P ≤ 0.001）。观察组患者术后并发症总发生率为 3.33%，低于对照组（23.33%），差异有显著性（P ＜ 0.05）。结论环状混合痔患者通过外剥内扎术联合吻合器痔上黏膜环切术治疗，可提升临床效果，有效改善肛门功能，并发症总发生率低。

关键词: 外剥内扎术, 吻合器痔上黏膜环切术, 环状混合痔, 肛门功能

Abstract:

Objective To study the effect of external stripping and internal ligation combined with stapled hemorrhoidectomy for the treatment of patients with mixed hemorrhoids and its impact on anal function. Method 60 patients with circular mixed hemorrhoids admitted to Mishan Traditional Chinese Medicine Hospital from January to December 2023 were randomly divided into two groups using a random number table. The control group (n=30) underwent external stripping and internal ligation treatment, while the observation group (n=30) received combined treatment with stapled hemorrhoidectomy on the basis of the control group. The clinical efficacy, recurrence rate, surgical indicators, postoperative complications, postoperative pain and anal function recovery, and anorectal motility indicators at different postoperative times were compared between the two groups of patients. Result The total clinical effective rate of the observation group was higher than that of the control group, the recurrence rate within 1 year was lower than that of the control group, and the postoperative visual analogue scale score and Williams standard rating were both lower than those of the control group, with significant differences (P ＜ 0.05). The surgical time, hospitalization time, and wound healing time of the observation group patients were shorter than those of the control group, and the intraoperative blood loss was less than that of the control group, with significant differences (P ＜ 0.001). One month after surgery, there was no significant difference in anorectal motility indicators between the two groups (P ＞ 0.05); Three months after surgery, both groups showed improvement in anorectal motility indicators compared to one month after surgery, and all indicators in the observation group were better than those in the control group, with significant differences (P ≤ 0.001). The total incidence of postoperative complications in the observation group was 3.33%, which was lower than that in the control group (23.33%), and the difference was significant (P ＜ 0.05). Conclusion Patients with mixed hemorrhoids can improve clinical outcomes, effectively improve anal function, and have a low incidence of complications when treated with external dissection and internal ligation combined with stapled mucosal excision.

Key words: External peeling and internal ligation technique, Stapler assisted hemorrhoidectomy, Circular mixed hemorrhoids, Anal function

庄国栋, 吴立伟. 外剥内扎术联合吻合器痔上黏膜环切术治疗环状混合痔患者的疗效及其对肛门功能的影响 [J]. 临床普外科电子杂志, 2025, 13(2): 81-.

Zhuang Guodong, Wu Liwei. The therapeutic effect of external stripping and internal ligation combined with stapler hemorrhoidectomy on patients with mixed hemorrhoids and its impact on anal function[J]. Journal of General Surgery for Clinicians, 2025, 13(2): 81-.

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