湖北科技学院学报（医学版）

目的 分析吻合器痔上黏膜环切(PPH)术对Ⅲ期环状混合痔患者的疗效及肛肠动力学的影响。方法 选择80例Ⅲ期环状混合痔患者，以随机数表法分成对照组和观察组，每组40例，对照组采取传统痔切除术，观察组采取PPH术治疗。对比两组痔愈合效果、临床指标[术中出血量、手术与创面愈合时长、术后1d视觉模拟评分(VAS)]、肛肠动力学指标[肛管最大收缩压(MSP)、肛管静息压(ARP)、直肠静息压(RRP)]及并发症发生情况。结果 观察组的总愈合率为97.50%,较对照组的80.00%高(P<0.05);观察组的手术时长、创面愈合时长较对照组短，术中出血量与术后1d VAS得分较对照组低(P均<0.05);与对照组相比，观察组术后1月ARP、MSP、RRP水平均更好(P均<0.05),及并发症发生率低(P<0.05)。结论 PPH术对Ⅲ期环状混合痔具有较高疗效，可有效改善患者的肛肠动力学情况，促进手术及术后康复进程，并可有效预防并发症，安全性较高。

Objective To analyze the effect of procedure for prolapse and hemorrhoids(PPH) on patients with stage Ⅲ mixed hemorrhoids and its impact on anorectal dynamics.Methods 80 patients with stage Ⅲ mixed hemorrhoids were randomly divided into a control group and an observation group, with 40 patients in each group.The control group received traditional hemorrhoidectomy, while the observation group received PPH treatment.The healing effects of hemorrhoids, clinical indicators [intraoperative blood loss, duration of surgery and wound healing, and postoperative visual analog scale(VAS)],anorectal dynamic indicators [maximum anal systolic pressure(MSP),anal resting pressure(ARP),rectal resting pressure(RRP)],and the incidence of complications between the two groups were compared.Results The total healing efficiency of the observation group was 97.50%,which was higher than the 80.00% of the control group(P<0.05);The surgical duration and wound healing time of the observation group were shorter than those of the control group, and the intraoperative blood loss and postoperative 1-day VAS score were lower than those of the control group(all P<0.05);Compared with the control group, the observation group showed the better levels of ARP,MSP and RRP(all P<0.05),and the lower incidence of complications(P<0.05).Conclusion PPH surgery has a high therapeutic effect on stage Ⅲ mixed hemorrhoids, which can effectively improve the patient's anorectal dynamics, promote the surgical and postoperative recovery process, and effectively prevent complications with high safety.