局部麻醉下Milligan-Morgan和Ligasure混合痔手术的对比分析

发布时间：2018-02-03 17:13

本文关键词： 麻醉局部外剥内扎术血管闭合系统混合痔　出处：《重庆医学》2015年11期 　论文类型：期刊论文

【摘要】：目的探讨局部麻醉下外剥内扎术(Milligan-Morgan)和血管闭合系统(Ligasure)两种不同混合痔切除术的临床疗效。方法选择2009年4月至2012年4月首都医科大学附属北京世纪坛医院普通外科行混合痔切除手术住院患者68例,分为Ligasure手术治疗34例(观察组)和Milligan-Morgan治疗34例(对照组),手术均采用局部浸润麻醉,术后随访6~36个月,比较两种手术方式的手术时间,术中出血量,总住院费用,术后住院时间、疼痛程度及并发症情况。结果对照组、观察组平均手术时间分别为(32.35±10.24)、(20.29±7.88)min,平均术中出血量分别为(29.71±14.67)、(4.97±2.89)mL,平均术后疼痛(最剧烈)分数分别为(5.88±1.12)、(3.47±0.83)分,平均术后住院时间分别为(7.97±2.55)、(2.29±1.17)d,平均住院费用分别为(1 541.32±205.91)、(2 872.32±652.30)元,两组比较均差异有统计学意义(P0.01)。住院期间及随访中,除对照组肛门渗液率和术后疼痛评分较观察组高外(P0.01);两组其他并发症发生率比较,均差异无统计学意义(P0.05)。结论 Ligasure术中出血量少,手术时间及术后住院时间短。
[Abstract]:Objective to investigate Milligan-Morganization under local anesthesia and the vascular closure system Ligasure). Methods from April 2009 to April 2012, 68 patients with mixed hemorrhoidectomy were treated with mixed hemorrhoidectomy in general surgery, Beijing Century altar Hospital affiliated to Capital Medical University. 34 cases were treated with Ligasure operation (observation group) and 34 cases with Milligan-Morgan (control group). Patients were followed up for 6 ~ 36 months. The operative time, blood loss, total hospitalization cost, postoperative hospitalization time, pain degree and complications were compared between the two groups. The mean operative time was 32.35 卤10.24 minutes and the average intraoperative bleeding volume was 29.71 卤14.67) in the observation group (20.29 卤7.88 min). The mean score of postoperative pain was 5.88 卤1.12mL and 3.47 卤0.83respectively. The average postoperative hospitalization time was 7.97 卤2.55 and the average hospitalization cost was 1.541.32 卤205.91). The difference between the two groups was statistically significant (P 0.01). The anal effusion rate and postoperative pain score in the control group were higher than those in the observation group (P 0.01). There was no significant difference in the incidence of other complications between the two groups (P 0.05). Conclusion the amount of blood loss during Ligasure is less, and the operation time and postoperative hospitalization time are short.
【作者单位】：北京大学第九临床医学院;首都医科大学附属北京世纪坛医院普通外科;
【基金】：铁道部专项课题资助项目(Z2011-016)
【分类号】：R657.18
【正文快照】： 在痔的外科手术中,外剥内扎术(Mil1igan-Morgan)是国内目前应用最多的术式,但手术相关的出血及疼痛问题一直未得到有效解决等。血管闭合系统(Ligasure)止血效果好,组织损伤轻,Sayfan等[1]将其率先应用在痔切除手术中,并取得良好效果。本院于2009年4月至2012年4月对68例混合痔

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