外剥内扎术联合选择性痔上粘膜切除吻合术(TST)治疗III、IV度混合痔的临床观察

Clinical Observation of the Grade III and IV Mixed Hemorrhoids Treated with the Combination of External Dissection, Internal Ligation, and Tissue-Selecting Therapy (TST)

摘要: 目的：探讨行混合痔外剥内扎术联合选择性痔上粘膜切除吻合术(TST)治疗III、IV度混合痔的临床效果。方法：回顾性分析我院III、IV度混合痔患者48例，均通过外剥内扎术联合选择性痔上粘膜切除吻合术(TST)治疗后，观察临床治疗效果。结果：48例III、IV度混合痔患者，其临床总有效率为97.91%，其中43例治愈，占89.58%；4例有效，占8.33%；1例无效，占2.08%。并发症发生率6.25%，1例术后创面水肿伴有疼痛，1例尿储留，1例肛门会阴坠胀。无术后大出血病例。随访6月~1年，未出现复发病例。结论：在临床上采用外剥内扎术联合TST治疗III、IV度混合痔，临床效果显著，值得临床推广。

Abstract: Objective: To investigate the clinical effect of grade III and IV mixed hemorrhoids treated with the combination of external dissection, internal ligation, and tissue-selecting therapy (TST). Methods: We performed a retrospective analysis of 48 patients with grade III and IV mixed hemorrhoids in our hospital. All the 48 patients were treated with external dissection and internal ligation first, then followed with tissue-selecting therapy (TST). The clinical therapeutic effects were observed and recorded. Results: In 48 patients with mixed hemorrhoids of grade III and IV, the total clinical effective rate was 97.91%. Among them, 43 were cured, accounting for 89.58%; 4 were effective, accounting for 8.33%; 1 was ineffective, accounting for 2.08%. The complication rate was 6.25%, in-cluding 1 case of postoperative wound edema and pain, 1 case of urine retention, and 1 case of anus and perineum bulge. There were no cases of postoperative massive hemorrhage. During the fol-low-up period of 6 months to 1 year, there was no recurrence. Conclusion: The clinical effect of ex-ternal dissection, internal ligation combined with TST in the treatment of mixed hemorrhoids of grade III and IV is remarkable. This combination treatment is worthy of clinical promotion.