| 王俊,马良欢,金黑鹰.外剥内扎术结合残余痔组织剥除、痔上黏膜套扎术治疗环状混合痔 137例疗效分析[J].安徽医药,2024,28(10):1952-1956. |
| 外剥内扎术结合残余痔组织剥除、痔上黏膜套扎术治疗环状混合痔 137例疗效分析 |
| Analysis of the effect of M-M procedure,excision of residual piles tissue and above mucosa ligation on 137 cases of circumferential mixed hemorrhoids |
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| DOI：10.3969/j.issn.1009-6469.2024.10.010 |
| 中文关键词: 混合痔 痔切除术 外剥内扎术结合残余痔组织剥除、痔上黏膜套扎术 选择性痔上黏膜切除术 临床研究 |
| 英文关键词: Mixed hemorrhoids Hemorrhoidectomy M-M procedure, excision of residual piles tissue and above mucosa ligation Tissue-selecting therapy stapler Clinical study |
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| 中文摘要: |
| 目的观察外剥内扎术结合残余痔组织剥除、痔上黏膜套扎术( M-M procedure，excision of residual piles tissue and above mucosa ligation，MEAL)治疗环状混合痔的临床疗效。方法收集 2019年 1月至 2020年 1月于南京中医药大学第二附属医院肛肠中心接受 MEAL的 54例环状混合痔病人作为实验组( MEAL组)；以同期 47例行单纯外剥内扎术( M-M组)和 36例行选择性痔上黏膜切除术(TST组)的病人为对照组，分别比较各组病人的住院时间、创面愈合时间、皮赘残留、痔疮复发、肛门狭窄及肛门失禁情况。结果随访时间为( 351.80±110.28)d，MEAL组的住院时间和对照组比较，差异无统计学意义(均 P>0.05)； MEAL组的创面愈合时间( 11.55±1.67)d短于 M-M组( 12.38±1.91)d及 TST组( 12.38±2.11)d，均差异有统计学意义(均 P<0.05)； MEAL组的痔疮复发率 1.85%(1/54)、皮赘残留发生率 18.52%(10/54)均低于 M-M组痔疮复发率 14.89%(7/47)、皮赘残留发生率 36.17%(17/47)及 TST组痔疮复发率 16.66%(6/36)、皮赘残留发生率 41.67%(15/36)差异有统计学意义(均 P<0.05)；全组均无肛门失禁及肛门狭窄病例。结论基于 M-M的 MEAL治疗环状混合痔具有减少创面、，降低复发率等优点，在保护肛门的同时，明显减少了皮赘残留的发生。 |
| 英文摘要: |
| Objectives To observe the clinical efficacy of MEAL (M-M procedure,Excision of residual piles tissue and Above mucosa Ligation) in the treatment of circumferential mixed hemorrhoids.Methods The clinical data of 54 patients with circumferential mixedhemorrhoids who underwent MEAL in the anorectal center of the Second Affiliated Hospital of Nanjing University of traditional Chinese medicine from January 2019 to January 2020 were collected as the experimental group (MEAL group). In the same period, 47 patients underwent Milligan-Morgan hemorrhoidectomy (M-M group) and 36 patients underwent Tissue-selecting Therapystapler (TSTgroup) were selected as the control group. The hospitalization time, wound healing time, residual skin tumor, hemorrhoids recurrence,anal stricture and anal incontinence of MEAL group, M-M group and TST group were compared.Results There was no significant difference in length of stay between MEAL group and control group (P>0.05). The wound healing time of MEAL group (11.55±1.67) days was shorter than that of M-M group control group (12.38±1.91) days and TST group (12.38±2.11) days, and the differences were statistically significant (both P<0.05). The recurrence rate of hemorrhoids in the MEAL group was 1.85% (1/54), and the incidence of residualskin tags was 18.52% (10/54), both lower than the recurrence rate of hemorrhoids [14.89% (7/47)] and the incidence of residual skintags [36.17% (17/47)] in the M-M group, and the recurrence rate of hemorrhoids [16.66% (6/36)] and the incidence of residual skin tags[41.67% (15/36)] in the TST group, with statistical significance (all P<0.05). There were no cases of anal incontinence or anal stenosis. Conclusions MEAL in the treatment of circumferential mixed hemorrhoids has the advantages of reducing the wound and the recurrence rate. It can protect the anus and significantly reduce the occurrence of residual skin. |
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