【作者】 王艳；

【导师】 王业皇；

【作者基本信息】 南京中医药大学 ， 中医学， 2012， 硕士

【摘要】 目的通过测量开环式微创痔吻合术、外切内扎术术前术后患者肛管直肠口径,观察术前术后患者肛管直肠口径的变化和肛门功能的观察评分,比较开环式微创痔吻合术和外切内扎术术后该肛管直肠口径的变化,及其变化对术后排便通畅程度的影响。方法选择40例病人,在签署知情同意书的前提下,按照随机原则分为治疗组和对照组。治疗组采用开环式微创痔吻合术(TST)治疗,对照组采用外切内扎术治疗,对两组病人的手术时间、术中出血量、术后肛管直肠口径的变化、排便通畅程度、急便感、肛门坠胀、术后脱出情况、术后出血情况、术后肛门功能、术后肛门疼痛情况、住院时间等方面进行比较。结果开环式微创痔吻合术(TST)的术后出血、脱出、排便通畅程度、急便感、肛门功能、手术时间、术中出血量、住院时间方面与外切内扎术相比均无统计学意义(P>0.05)；开环式微创痔吻合术(TST)在术后肛管直肠口径的变化、术后肛门疼痛、术后肛门坠胀方面与外切内扎术相比均有统计学意义(P<0.05)。结论开环式微创痔吻合术(TST术)在治疗脱垂性痔病术后脱垂、出血、排便通畅程度、急便感、肛门自制功能、手术时间、术中出血量、住院时间方面与对照组相似,在减小术后肛管直肠口径的变化、术后肛门疼痛方面开环式微创痔吻合术(TST术)较外切内扎术具有明显的优势,在术后肛门坠胀方面外切内扎术相对于开环式微创痔吻合术(TST术)具有明显的优势。更多还原

【Abstract】 Objective:By measuring the Tissue-Selecting Therapy stapler with Milligan-Morgan of preoperative and postoperative patients with anal canal diameter measurement, observation of preoperative and postoperative patients with anal canal diameter change and anal function observed score proved TST can effectively maintain the anal pad and the anal mucosa integrity, and its changes on postoperative bowel patency degree of influence.Methods:Select40patients with Ⅲ-Ⅳ degree prolapsed hemorrhoids, according to randomly assigned into treatment group (Tissue-Selecting Therapy stapler TST group) and control group (Milligan-Morgan M-Mgroup) to observed the two groups of patients after treatment, the duration of operation, intraoperative blood loss, postoperative anal canal diameter changes,defecate unobstructed degree, urgent sense, anus pendent bulge, postoperative prolapse cases, postoperative bleeding, postoperative anal function, postoperative anal pain, hospitalization time and other aspects comparison.Results:No difference in the postoperative bleeding, prolapse, defecate unobstructed degree, urgent sense, anal homemade function, operation time, intraoperative blood loss, length of stay (P>0.05); while TST in postoperative anal canal diameter changes, postoperative anal pain, postoperative anal bulge with M-M are statistically significant (P<0.05).Conclusion:The two operation styles for treatment of postoperative prolapse, bleeding, bowel patency, urgent, anal homemade function, operation time, intraoperative blood loss, length of stay in terms of similar efficacy,while in reducing postoperative anal canal diameter changes, postoperative anal pain TST than M-M has obvious advantages, in the postoperative anus pendent bulge with respect to the outer M-M relative to TST have a distinct advantage。更多还原