本文選題：痔瘡手術(shù) + 普勒引導(dǎo)下痔瘡動脈結(jié)扎　； 參考：《大連醫(yī)科大學(xué)》2017年碩士論文

【摘要】：研究背景:痔瘡是外科診所最常處置的疾病之一,3度以上痔瘡?fù)枰中g(shù)切除才能得到徹底的治療,但傳統(tǒng)手術(shù)所帶來的疼痛往往不易藉由開立的口服藥得到良好的控制,新式的手術(shù)如Ligasure閉合系統(tǒng)輔助痔瘡切除法及多普勒超聲引導(dǎo)下痔動脈結(jié)扎配合痔黏膜懸吊術(shù)是目前許多外科診所廣泛運用的門診手術(shù),兩者不但有良好的治愈率,且術(shù)后疼痛遠較傳統(tǒng)milligan-morgan外剝內(nèi)扎法輕微。研究目的:比較上述兩種手術(shù)的優(yōu)劣及何種方式適合應(yīng)用于3度以上痔瘡門診手術(shù)研究方法:在2015年1至6月間選取3度以上痔瘡病患80人次,并隨機分成兩組,其中試驗組病患接受多普勒超聲引導(dǎo)下痔動脈結(jié)扎配合痔黏膜懸吊術(shù)治療,而對照組則是以Ligasure閉合系統(tǒng)輔助痔瘡切除法治療,術(shù)后就病患的疼痛,治愈率及手術(shù)滿意度作統(tǒng)計分析研究結(jié)果:雖然在術(shù)后治愈率及肛門贅皮、2度手術(shù)上試驗組的表現(xiàn)較差,但是試驗組術(shù)后疼痛上則遠較輕微,而術(shù)后滿意度上試驗組還是表現(xiàn)較佳(p0.001)研究結(jié)論:多普勒超聲引導(dǎo)下痔動脈結(jié)扎配合痔黏膜懸吊術(shù)術(shù)治愈率高,術(shù)后疼痛輕微,多數(shù)病患不會因為疼痛再度返院,而Ligasure閉合系統(tǒng)輔助痔瘡切除法雖然治愈率較高,但術(shù)后疼痛及24小時內(nèi)返院,病患滿意度皆不如多普勒超聲法,因此在診所門診手術(shù)上還是建議以多普勒超聲引導(dǎo)下痔動脈結(jié)扎配合痔黏膜懸吊術(shù)術(shù)作為3度以上痔瘡的優(yōu)先選擇。
[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.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R657.18

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