“直视两针法”技术在PPH手术中的临床对照研究

发布时间：2018-04-26 05:27

本文选题：直视两针法 + 荷包缝合　；参考：《实用医学杂志》2017年07期

【摘要】：目的:通过前瞻性随机对照研究,探讨"直视两针法"等技术改进对PPH手术操作过程及效果的影响。方法:将我科行PPH术的683例病例随机分为两组,观察组术中进行"直视两针法"等技术改进,对照组按照标准手术操作流程操作,比较两组手术时间、术中出血量、术后标本宽度、术后并发症等。结果:观察组350例,手术时间平均(12.2±4.0)min,术中出血量(4.95±2.82)m L,标本宽度(2.61±0.32)cm,术后出血行止血手术2例,术后痔区水肿或血栓5例;对照组333例,手术时间平均(17.2±3.6)min,术中出血量(7.55±3.94)m L,标本宽度(1.18±0.56)cm,术后出血行止血手术5例,术后痔区水肿或血栓14例,术后感染1例,直肠狭窄1例,直肠阴道瘘1例。观察组手术时间较短,切除宽度、深度适宜,术后严重并发症少见。结论:"直视两针法"等技术改进,降低手术操作难度,简便、安全、有效。
[Abstract]:Objective: to investigate the effect of "direct vision two-needle method" on the operation process and effect of PPH by prospective randomized controlled study. Methods: 683 cases of PPH were randomly divided into two groups. The observation group was treated with "direct vision and two needles" and the control group was operated according to the standard operation procedure. The operation time and blood loss were compared between the two groups. Postoperative specimen width, postoperative complications and so on. Results: there were 350 cases in the observation group, the average operation time was 12.2 卤4.0 min, the intraoperative bleeding volume was 4.95 卤2.82 mL, the width of the specimen was 2.61 卤0.32 cm, the bleeding hemostasis was performed in 2 cases, the hemorrhoid edema or thrombus occurred in 5 cases, the control group was 333 cases. The mean operative time was 17.2 卤3.6 min, the mean intraoperative bleeding volume was 7.55 卤3.94 mL, the width of the specimen was 1.18 卤0.56 cm, the hemostasis was performed in 5 cases, hemorrhoids edema or thrombus in 14 cases, postoperative infection in 1 case, rectal stenosis in 1 case, rectovaginal fistula in 1 case. In the observation group, the operation time was shorter, the width and depth of resection were suitable, and serious postoperative complications were rare. Conclusion: the technique of "direct vision and two needles" can reduce the difficulty of operation, be simple, safe and effective.
【作者单位】：北京市肛肠医院北京二龙路医院肛肠外科;
【分类号】：R657.18

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