摘要目的 比较吻合器痔上黏膜环切钉合术(PPH)与Milligan.Morgan(MM)术对重度痔的远期疗效.方法 对2001年5月至2005年5月间因Ⅲ度、Ⅳ度痔行PPH的91例和MM术的102例患者进行随访.比较两组患者术后症状缓解情况、治愈情况和并发症及复发情况.结果 PPH和MM术均明显缓解了便血(95.6%比92.7%)、疼痛(93.1%比94.3%)、脱垂(93.4%比93.1%)等症状,两组比较,差异无统计学意义(P>0.05).PPH组术后排便困难的缓解率优于MM术组(60.0%比32.1%.P<0.05).PPH和MM术对不同分度、类型及脱垂程度痔的治愈率比较.差异均无统计学意义(P>0.05).两组术后总体并发症发生率(14.3%比12.7%)、复发率(12.1%比8.8%)及满意度(85.1vs 88.2)比较,差异也无统计学意义(P>0.05 o结论PPH治疗Ⅲ度、Ⅳ度痔的远期疗效及安全性与MM术相同.

abstractsObjective To compare the long-term results of procedure for prolapse and hemorrhoids (PPH) and Milligan-Morgan (MM) hemorrhoideetomy in the treatment of third- and fourth-degree hemorrhoids. Methods Ninety-one patients in PPH group and 120 patients in MM group,treated in our hospital from May 2001 to May 2005, were foilowedup. All the patients suffered with third- or fourth-degree hemorrhoids. The data including symptoms relief, complication and recurrenee were compared between two groups. Results PPH and MM both significantly relieved bleeding (95.6% vs 92.7%), pain (93.1% vs 94.3%) and prolapse (93.4% vs 93.1%). There were no significant differences between two groups (P>0.05). PPH significantly relieved constipation compared with MM (60.0% vs 32.1%, P<0.05). No significant differences of complete relief rates between PPH group and MM group according to different degrees, types and prolapses of hemorrhoids were found (P>0.05).There were no significant differences in the overall complication rate (14.3% vs 12.7%), recurrence rates(12.1% vs 8.8%) and satisfactory degree (85.1 vs 88.2) between two groups as well. Conclusion The long-term outcomes of PPH in the treatment of third and fourth-degree hemorrhoids are similar to Milligan-Morgan hemorrhoideetomy.