|
|
|
| Clinical Study on the Combined Treatment of Anatomical Hemorrhoidectomy with Semi-Closed Suturing and Mucosal Ligation above Hemorrhoid for Mixed Hemorrhoids |
| LU Wei, ZHU Guangyan, LI Ruihao |
| Department of Surgery, Dayu Health Center of Jiyuan, Jiyuan Henan 459000 |
|
|
|
|
Abstract 【Objective】 To investigate the clinical efficacy of anatomical hemorrhoidectomy with semi closed suture combined with stapled mucosal ligation for the treatment of mixed hemorrhoids. 【Methods】 Clinical data of 86 patients with mixed hemorrhoids admitted to the Department of Surgery, Dayu Health Center of Jiyuan, from May 2023 to September 2024 were retrospectively analyzed. The patients were divided into an observation group and a control group according to the surgical method, with 43 cases in each group. The control group received conventional Milligan Morgan hemorrhoidectomy (external dissection and internal ligation), while the observation group was treated with anatomical hemorrhoidectomy with semi closed suture combined with stapled mucosal ligation. The two groups were compared in terms of stress response indicators [cortisol (Cor), adrenocorticotropic hormone (ACTH)], anorectal manometric parameters [anal resting rectal pressure (ARRP), anal maximum contractile pressure (AMCP), anal resting pressure (ARP)], postoperative complication rate, and pain intensity assessed by Visual Analogue Scale (VAS) at 6 h, 12 h, and 24 h postoperatively. 【Results】 At 1 day after surgery, serum Cor and ACTH levels in both groups were significantly higher than their preoperative levels (all P<0.05), however, there were no statistically significant differences between the two groups (all P>0.05). The VAS scores in the observation group at 6 h, 12 h, and 24 h postoperatively were all lower than those in the control group, with statistically significant differences (all P<0.05). At 1 month after surgery, ARRP, AMCP, and ARP in both groups were higher than the preoperative values, and the observation group showed significantly higher values than the control group (all P<0.05). The complication rate in the observation group was 9.30% (4/43), which was significantly lower than that in the control group [25.58% (11/43), χ2=3.957, P<0.05]. 【Conclusion】 Anatomical hemorrhoidectomy with semi closed suture combined with stapled mucosal ligation for treatment of mixed hemorrhoids can effectively alleviate stress responses, reduce postoperative pain, improve anorectal manometric function, and decrease the incidence of postoperative complications.
|
|
Received: 17 December 2025
|
|
|
|
|
|
[1] 陈旭渊,罗仕云,李文忠,等. 肛门整复术联合改良外剥内扎术治疗多发性混合痔的应用价值分析[J]. 河北医学,2024,30(4):674-678.
[2] 刁永峰,夏力. 聚多卡醇泡沫硬化剂联合外剥内扎术治疗中重度混合痔的疗效观察[J]. 中国临床医生杂志,2025,53(5):626-629.
[3] 史冰花,孙花,史冰田,等. 自动弹力线痔疮套扎术联合外剥内扎术治疗重度混合痔的疗效观察[J]. 中国现代手术学杂志,2025,29(3):190-194.
[4] 周海洋,冯六泉,石玮,等. 自动痔疮套扎术结合外剥后锁边缝合治疗Ⅲ度混合痔的效果分析[J]. 中国现代医学杂志,2025,35(2):56-60.
[5] 袁可,雷银福,陈丽娜,等. 解剖性痔切除半闭锁缝合联合痔上黏膜结扎术治疗混合痔的临床疗效观察[J]. 结直肠肛门外科,2022,28(3):266-270.
[6] 中国中西医结合学会大肠肛门病专业委员会. 中国痔病诊疗指南(2020)[J]. 结直肠肛门外科, 2020, 26(5): 519-533.
[7] 陈卓,于航,武海阔,等. 混合痔外剥内扎术相关优化改良研究进展[J]. 中国中西医结合外科杂志,2025,31(3):359-362.
[8] 季恩敏,张文生,李昌权,等. 弹力线套扎手术与吻合器痔上黏膜环切钉合手术治疗混合痔患者的疗效比较[J]. 实用临床医药杂志,2025,29(13):104-108.
[9] 林国辉,李燕萍,林延宗. 改良TST联合完整肛管上皮保留手术治疗环型混合痔的有效性和安全性分析[J]. 北京生物医学工程,2025,44(2):158-164.
[10] 汪磊,张灵博,朱书斌,等. 自动套扎术联合黏膜环切术对脱垂性混合痔合并便秘患者肠道功能及疼痛介质水平的影响[J]. 中国医刊,2025,60(10):1215-1219.
[11] 史冰花,窦海鹏,李俊莹,等. 吻合器痔上黏膜环切钉合术联合超声引导下痔上动脉结扎治疗Ⅲ度混合痔的疗效[J]. 中国现代手术学杂志,2024,28(6):449-453.
[12] 王娟,朱延新,崔莹莹. 老年混合痔患者术后水肿疼痛现状及影响因素[J]. 中华老年多器官疾病杂志,2024,23(8):572-575.
[13] 刘东锋,徐云峰,刘志军,等. TST联合消痔灵注射术与M-M术治疗混合痔的效果观察[J]. 内蒙古医科大学学报,2024,46(5):477-479.
[14] 江军建,万子昂. 解剖性痔切除半闭锁缝合联合痔上黏膜结扎术治疗混合痔的效果观察[J]. 浙江创伤外科,2025,30(3):521-523.
[15] 王俊,马良欢,金黑鹰. 外剥内扎术结合残余痔组织剥除、痔上黏膜套扎术治疗环状混合痔137例疗效分析[J]. 安徽医药,2024,28(10):1952-1956. |
| [1] |
. [J]. JOURNAL OF CLINICAL RESEARCH, 2026, 43(7): 1193-1195. |
|
|
|
|
2026, Vol. 43 
