Abstract：Objective To study the effect of Treitz muscle preservation with small V-incision combined with procedure for prolapse and hemorrhoids (PPH) in the treatment of mixed hemorrhoids. Methods A total of 80 patients with mixed hemorrhoids admitted to the People’s Hospital of Xuancheng City of Anhui Province from June 2017 to January 2021 were selected as the research subjects, and they were divided into study group and control group according to random number table method, with 40 patients in each group. The control group was treated with PPH, and the research group was treated with Treitz muscle preservation with small V-incision on the basis of PPH. The clinical effective rate, anal distention, anal pain, urination status, incidence of complications and safety were analyzed and compared between the two groups. Results The clinical efficacy of the study group was better than that of the control group, and the difference was statistically significant (P ＜ 0.05). Twenty-four h after surgery, the degree of anal distension, pain, and urination status score of both groups were significantly lower than those of 6 h after surgery, the differences were statistically significant (P ＜ 0.05). At 6 and 24 h after surgery, the degree of anal distension, pain and urination status score in the study group were significantly lower than those in the control group, and the differences were statistically significant (P ＜ 0.05). The incidence of complications in the study group was significantly lower than that in the control group, the differences were statistically significant (P ＜ 0.05). There were no adverse reactions such as nausea and vomiting, dizziness and obstructive breathing, abnormal liver and kidney function, and the safety was good in the two groups. Conclusion Treitz muscle preservation with small V-incision combined with PPH has good clinical efficacy in the treatment of mixed hemorrhoids and can effectively reduce postoperative anal distension and pain, which is a safe and effective treatment.
赵世明 陈银 何建林. 小V型切口Treitz肌保存术联合PPH治疗混合痔的效果[J]. 中国医药导报, 2022, 19(7): 108-111.
ZHAO Shiming CHEN Yin HE Jianlin. Efficacy of Treitz muscle preservation with small V-incision combined with PPH in the treatment of mixed hemorrhoids #br#
#br#. 中国医药导报, 2022, 19(7): 108-111.
[1] Ray-OE，Amadi S. Hemorrhoidal disease：Predilection sites，pattern of presentation，and treatment [J]. Ann Afr Med. 2019，18（1）：12-16.
[2] Wu J，Yu K，Lv C，et al. Segmental resection combined with anoplasty for the treatment of circumferential mixed hemorrhoids [J]. Braz J Med Biol Res，2019，52（5）：e8102.
[3] Angela RS，Lawrence Z. Advances and Annoyances in Anus Pathologyl [J]. Surg Pathol Clin，2020，13（3）：557-566.
[4] 吕智豪，郭昌，文彬，等.外剥内套法治疗Ⅲ、Ⅳ度混合痔[J].实用医学杂志，2019，35（21）：3304-3307.
[5] Xu L，Chen H，Gu Y. Stapled Hemorrhoidectomy Versus Transanal Hemorrhoidal Dearterialization in the Treatment of Hemorrhoids：An Updated Meta-Analysis [J]. Surg Laparosc Endosc Percutan Tech，2019，29（2）：75-81.
[6] 顾雪萍，孙玲芳.超选择直肠上动脉栓塞术（SRAE）与吻合器痔上黏膜环切钉合术（PPH）治疗痔的回顾性研究[J].复旦学报：医学版，2020，47（2）：275-279，292.
[7] 雷新益，张志云，吉祖进，等.RPH联合外剥内扎术与PPH治疗重度混合痔的临床效果比较[J].实用医学杂志，2018，34（12）：2049-2052.
[8] 周霜，李慧，孟淑华.指状式冰敷模型在吻合器痔上黏膜环切术中及术后的应用效果[J].解放军护理杂志，2018， 35（13）：68-70.
[9] 何峰.小“V”形切口Treitz肌保存术治疗混合痔的临床研究[D].贵阳：贵阳中医学院，2008.
[10] 中华中医药学会.中医肛肠科常见病诊疗指南[M].北京：中国中医药出版社，2012：61.
[11] Issue Information-Declaration of Helsinki [J]. J Bone Miner Res，2018，33（4）：BM i-BM ii.
[12] 中华中医药学会肛肠病专业委员会.痔临床诊治指南（2006版）[J].中华胃肠外科杂志，2006，9（5）：461-463.
[13] 郑筱萸.中药新药临床研究指导原则[M].北京：中国医药科技出版，2002：1229-1234.
[14] Longo A. Treatment of hemorrhoids disease by reduction of mucosa and hemorrhoidal proplase with a circular sutuning device： a new procedure [M]. Rome. Ltaly：proceedings of the 6th world congredd of Endoscopic Surgery，1998：3-4.
[15] Yu JH，Huang XW，Wu ZJ，et al. Clinical study of use of large C suture in procedure for prolapse and hemorrhoids for treatment of mixed hemorrhoids [J]. J Int Med Res，2021，49（3）：300060521997325.
[16] 叶辉，周启昌，龚治林，等.血栓剥除联合痔上黏膜环切钉合术治疗嵌顿性环状混合痔的疗效分析[J].重庆医学，2017，46（14）：1938-1940.
[17] 杨豪杰，刁海彦，刘华.痔术后中药外治疗效的Meta分析[J].辽宁中医杂志，2017，44（12）：2465-2473.
[18] Mott T，Latimer K，Edwards C. Hemorrhoids：Diagnosis and Treatment Options [J]. Am Fam Physician，2018，97（3）：172-179.
[19] Lee KY，Lee JI，Park YY，et al. Hemorrhoids Are Associated with Urinary Incontinence [J]. J Womens Health （Larchmt），2020，29（11）：1464-1468.
[20] Davis BR，Lee-Kong SA，Migaly J，et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids [J]. Dis Colon Rectum，2018，61（3）：284-292.
[21] Idrees JJ，Clapp M，Brady JT，et al. Evaluating the Accuracy of Hemorrhoids：Comparison Among Specialties and Symptoms [J]. Dis Colon Rectum，2019，62（7）：867-871.
[22] 齐晓燕，马珊珊，侯芳.循证护理干预在吻合器痔上黏膜环切术治疗直肠黏膜脱垂中的应用[J].中国临床研究，2021，34（2）：286-288.
[23] 高敏，朱鹏，唐云昊.吻合器痔上黏膜环切术与改良痔环切术治疗环状混合痔的临床疗效比较[J].重庆医科大学学报，2016，41（12）：1294-1297.
[24] 王其，欧阳军，王蒙，等.开环式吻合器痔上黏膜环形切除术治疗环状痔患者的临床效果[J].中国医药导报，2021， 18（11）：133-136.
[25] Iida Y，Saito H，Takashima Y，et al. Procedure for prolapsed and hemorrhoids（PPH）with low rectal anastomosis using a PPH 03 stapler：low rate of recurrence and postoperative complications [J]. Int J Colorectal Dis，2017， 32（12）：1687-1692.
[26] 杜川林，赖象权，陈昱江，等.小“V”形切口Treitz肌保存术治疗混合痔临床疗效的病理分析[J].实用医学杂志，2020，36（11）：1473-1477.
[27] 赵海鹏.PPH联合小“V”切口外痔剥除术治疗重度混合痔的效果及价值体会[J].中国全科医学，2019，22（S2）：95-97.
京公网安备 11010502046598号