保留肛管上皮系痔法治疗混合痔的临床应用研究.pdf

南京中医药大学硕士学位论文保留肛管上皮系痔法治疗混合痔的临床研究姓名:文科申请学位级别:硕士专业:中医外科肛肠病学指导教师:谷云飞 20080501 :探索在混合痔的治疗中,完整保留肛管上皮,保留齿线区感觉上皮,在保证疗效的前提下,缩短创面愈合时间、减轻患者痛苦、最大限度地保护肛门功能的新方法。方法:选择混合痔住院病人20例,随机分为两组,治疗组109,l,对照组10例,治疗组采用保留肛管上皮系痔法,对照组采用传统的外剥内扎术。分别对两组患者手术所用时间、临床疗效、术后并发症、创面愈合时间、手术前后肛管周长等指标进行了观察统计。结果:运用保留肛管上皮系痔法治疗混合痔,同采用传统外剥内扎术相比,其临床治愈率,复发率、手术操作时问、术后疼痛、尿潴留,出血、肛门控便功能发生率上等无明显统计学差异(P>)。两组患者创面愈合时间、术后肛门坠胀、排便、水肿比较差异有统计学意义(P<)。在手术前后的肛管周长比较上,治疗组术前术后变化不大(P>),对照组术后较术前明显缩小(P<)。结论:保留肛管上皮系痔法治疗混合痔在保证治愈率的基础上,能有效保留肛管上皮, 保护肛门正常结构和功能,缩短创面愈合时间,减少术后并发症及后遗症。关键词:混合痔;肛管上皮;系痔法;并发症 ABSlRACr RETA NANAL CANAL EP THEL UM AND DEL GAT 0N 0F HEMORRHO DS NTHE TREATMENT 0F M XED HEMORRHO DS ABSTRACT Objective:To evaluate a new operation procedure in the treatment of mixed hemorrhoids that is not only more retainentire analcanalepithelium and linea’S sense epithelium,but alsoprotectanal function well,has lesssufferingand ashorter course of treatment plication. Methods:Twenty samples ale divided into twogroups(n=10).The therapy group adopts retainanal canal epithelium and deligation ofhemorrhoids;the controlgroup adopts the traditional external dissection and internal andanalyzing theclinical curative effect,time ofoperation andtreatment,plications andanal canal’Sperimeter before orafteroperation. Results:Two groups have no obvious differences inthehealing rate, recurrence half year afteroperation rate,operation time,the happening ofpainuroschesis,breeding, andanalcontrol ofsedes(P>).The course oftreatment and the rateofconstipation, edema fort aledifferent(P<).The measure ofanalcanal’Sperimeter before or after Operation suggests thatThe therapy group have no obvious change (P>), and thecontrolgroup grow downwards obviously(P<). Conclusion:On thebasis of ensure of cure rate, retainanal canal epithelium and deligation ofhemorrhoid inthe treatofmixed hemorrhoids can retainentireanalcanal epithelium efficiently, retainbetterphysiological func