多普勒引导下痔疮动脉结扎配合痔黏膜悬吊术与ligasure闭合器辅助痔疮切除术在3度以上痔疮的疗效比较

发布时间：2018-06-02 13:14

本文选题：痔疮手术 + 普勒引导下痔疮动脉结扎　；参考：《大连医科大学》2017年硕士论文

【摘要】：研究背景:痔疮是外科诊所最常处置的疾病之一,3度以上痔疮往往需要手术切除才能得到彻底的治疗,但传统手术所带来的疼痛往往不易藉由开立的口服药得到良好的控制,新式的手术如Ligasure闭合系统辅助痔疮切除法及多普勒超声引导下痔动脉结扎配合痔黏膜悬吊术是目前许多外科诊所广泛运用的门诊手术,两者不但有良好的治愈率,且术后疼痛远较传统milligan-morgan外剥内扎法轻微。研究目的:比较上述两种手术的优劣及何种方式适合应用于3度以上痔疮门诊手术研究方法:在2015年1至6月间选取3度以上痔疮病患80人次,并随机分成两组,其中试验组病患接受多普勒超声引导下痔动脉结扎配合痔黏膜悬吊术治疗,而对照组则是以Ligasure闭合系统辅助痔疮切除法治疗,术后就病患的疼痛,治愈率及手术满意度作统计分析研究结果:虽然在术后治愈率及肛门赘皮、2度手术上试验组的表现较差,但是试验组术后疼痛上则远较轻微,而术后满意度上试验组还是表现较佳(p0.001)研究结论:多普勒超声引导下痔动脉结扎配合痔黏膜悬吊术术治愈率高,术后疼痛轻微,多数病患不会因为疼痛再度返院,而Ligasure闭合系统辅助痔疮切除法虽然治愈率较高,但术后疼痛及24小时内返院,病患满意度皆不如多普勒超声法,因此在诊所门诊手术上还是建议以多普勒超声引导下痔动脉结扎配合痔黏膜悬吊术术作为3度以上痔疮的优先选择。
[Abstract]:Background: hemorrhoids is one of the most commonly treated diseases in surgical clinics. Hemorrhoids usually require surgical excision in order to be thoroughly treated. However, the pain caused by traditional surgery is not always well controlled by oral administration. New types of surgery, such as Ligasure closure system assisted hemorrhoidectomy and Doppler ultrasound guided hemorrhoid artery ligation combined with hemorrhoid mucosal suspension, are now widely used in many surgical clinics, and both have a good cure rate. The postoperative pain was much less severe than that of milligan-morgan external stripping and internal ligation. Objective: to compare the advantages and disadvantages of the above two kinds of operations and which methods are suitable for the outpatient operation of hemorrhoids above 3 degrees. From January to June 2015, 80 patients with hemorrhoids above 3 degrees were selected and randomly divided into two groups. The patients in the experimental group were treated with ligation of hemorrhoid artery and suspension of hemorrhoid mucosa under the guidance of Doppler ultrasound, while those in the control group were treated with Ligasure closure system assisted hemorrhoidectomy. The results of statistical analysis of cure rate and surgical satisfaction were as follows: although the performance of the experimental group was worse in the postoperative cure rate and the second degree operation of anal neoderma, the pain in the trial group was far less severe after operation. Conclusion: under the guidance of Doppler ultrasound, hemorrhoids artery ligation combined with hemorrhoid mucosal suspension has a high cure rate and mild postoperative pain. Most patients will not return to hospital because of the pain. Although the cure rate of Ligasure closed system assisted hemorrhoidectomy was high, the patients' satisfaction was not as good as that of Doppler ultrasound. Therefore, Doppler ultrasound guided hemorrhoid artery ligation combined with hemorrhoid mucosal suspension is recommended as the preferred choice for hemorrhoids above 3 degrees in outpatient clinic.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.18

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