目的：探讨外切内注辅助改良 PPH 术治疗环状混合痔的近期疗效。方法将符合环状混合痔纳入标准的142例患者按不同术式分为2组，治疗组（70例）采用外切内注辅助改良 PPH 术，对照组（72例）采用内扎内注外切术。观察2组病例术后24 h 疼痛程度、出血情况，术后第3天肛缘水肿、肛门坠胀、肛门狭窄和尿潴留等并发症发生情况。记录术后住院时间、恢复正常生活或工作时间。结果2组患者术后24 h 疼痛评分、出血情况、术后3 d肛门水肿、肛门坠胀及术后住院时间和恢复正常工作或生活时间差异有统计学意义（P ＜0．01），术后尿潴留发生率差异无统计学意义（P ＞0．05）。2组患者治愈率均为100％，术后近期均未发生肛门失禁、肛门狭窄及直肠阴道漏等严重并发症，远期疗效有待观察。结论外切内注辅助改良 PPH 在治疗环状混合痔疼痛程度轻，术后并发症少，恢复快，近期疗效优势明显。%Objective To explore the short-term effects of external excision and internal injec-tion sclerotherapy-assisted improved procedure for prolapsed hemorrhoids(PPH)on circumferen-tial mixed hemorrhoids.Methods A total of 142 patients with circumferential mixed hemorrhoids were divided into two groups.The treatment group(n=70)received external excision and internal injection sclerotherapy-assisted improved PPH.The control group(n=72)received internal liga-tion,internal injection sclerotherapy and external excision.The pain and bleeding were observed at 24 hours after operation.The anal margin edema,anal pendant expansion,anal stenosis,urinary retention and other complications were observed at 3 days after operation.In addition,the length of postoperative hospital stay and time to resuming to normal living or working were recorded. Results Pain score and bleeding at 24 hours after operation,anal margin edema and anal pendant expansion at 3 days after operation,and length of postoperative hospital stay and time to resuming to normal living or working in treatment group were significantly different from those in control group(P <0.01),the incidence of posto perative urinary retention there was no statitically signifi-cant difference(P >0.05).The cure rate was 100% in both groups.No anal incontinence,anal ste-nosis,rectovaginal fistula and other complications were found in all patients.However,the long-term efficacy needed to be observed.Conclusion External excision and internal injection sclero-therapy-assisted improved PPH can reduce pain and postoperative complications and promote re-covery in patients with circumferential mixed hemorrhoids.
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