Objective To compare the curative effect of procedure for prolapse and hemorrhoids (PPH) with MilliganMorgan hemorrhoidectomy (MMH) for acute incarcerated hemorrhoids. Methods A retrospective study of 103 patients with acute incarcerated hemorrhoids treated by surgery was performed. The patients were divided into PPH group (n=58) and MMH group (n=45) according to the different operation program who underwent. Operative time, pain score of VAS, time required for anodyne, postoperative complications, hospital stay, and hospital charges were compared. Results The symptoms were both relieved in two groups patients. Although the hospital charges of patients in MMH group were fewer, the patients in PPH group had advantages of shorter operative time, less postoperative pain, lower requirement for anodyne, fewer complications (edema of anal edge), and shorter hospital stay (Plt;0.01). Conclusion PPH is as safe and effective as MMH, and furthermore its short-term therapeutic effect is better than MMH.
目的 探討在局部麻醉下行痔上黏膜環形切除釘合術（procedure for prolapse and hemorrhoids，PPH）治療重度內痔的可行性及臨床應用價值。方法 筆者所在醫院科室從2005年起對32例Ⅲ度及Ⅳ度脫垂性內痔（含1例混合痔）患者均采用苯巴比妥＋氫溴酸東莨菪堿＋利多卡因肛管直腸環形局部浸潤麻醉行PPH術，對其麻醉效果、手術時間、術中及術后疼痛、尿潴留、術后感染、肛門狹窄、住院時間、治療滿意度等進行分析。結果 32例患者均順利完成手術，有1例術中改行低位連續硬膜外麻醉，1例輔加鎮靜劑及鎮痛劑。術后28例對疼痛能耐受，4例需鎮痛藥物；1例患者有肛門墜脹感；所有患者傷口均一期愈合，無尿潴留、術后感染、出血、肛門狹窄等并發癥發生；31例對療效滿意，有1例感肛門墜脹，行溫水坐浴及痔瘡膏納肛治療1周后緩解。住院時間3～6d，平均4d。32例患者均進行有效隨訪，隨訪時間2～4個月，平均3個月，無大便失禁或復發，肛門控便能力均可。結論 局部麻醉下行PPH術治療重度內痔是一種安全可行的手術方法，麻醉操作護理簡單，療效確切，術后并發癥少，術后恢復快，并可減少醫療費用。
