Clinical Research Of Point Ligation And Suspension Of Hemorrhoid Mucosa Combined With Milligan-Morgan Hemorrhoidectomy In The Treatment Of Mixed Hemorrhoids With Grade Ⅲ And Ⅳ Internal Hemorrhoids

Objective:To observe the clinical effect of point ligation and suspension of hemorrhoid mucosa combined with Milligan-Morgan hemorrhoidectomy in the treatment of mixed hemorrhoids with grade III and IV internal hemorrhoids.Methods:A total of 60 patients of mixed hemorrhoids with grade III and IV internal hemorrhoids who were hospitalized in the department of anorectal surgery of Nanjing Hospital of Chinese medicine from November 2019 to November 2021 were selected and randomly divided into two groups.3.0 patients in the experimental group were treated with point ligation and suspension of hemorrhoid mucosa combined with Milligan-Morgan hemorrhoidectomy,while 30 patients in the control group were treated with Milligan-Morgan hemorrhoidectomy.Aspects such as the general indicators(gender,age,disease course and stages of hemorrhoids),operation time,postoperative pain(2nd,3rd and 7th day after operation),postoperative edema of wound margin(2nd,3rd and 7th day after operation),postoperative urinary retention in 24h,postoperative massive hemorrhage,anal stenosis(30 days after operation),healing time,clinical efficacy,patient’s satisfaction and postoperative recurrence(4 months after operation)were compared between the two groups.Results:(1)There was no significant difference in the patient’s general indicators such as gender,age,disease course and stages of hemorrhoids between the two groups(P>0.05).(2)There was no significant difference in the operation time,postoperative urinary retention in 24h,postoperative massive hemorrhage and clinical efficacy between the two groups(P>0.05).(3)Postoperative pain:The postoperative pain scores of the experimental group and the control group on the 2nd,3rd and 7th day after operation were observed,and the differences between the two groups at each time point were statistically significant(P<0.05).(4)Postoperative edema of wound margin:There were significant differences in the scores of edema of wound margin on the 2nd,3rd and 7th day after operation between the two groups(P<0.05).(5)Anal stenosis:The anal stenosis of the two groups 30 days after operation was observed,and the difference was statistically significant(P<0.05).(6)Healing time:The difference of healing time between the experimental group and the control group was statistically significant(P<0.05).(7)Patient satisfaction:The difference between the two groups was statistically significant(P<0.05).(8)Postoperative recurrence:The difference between the two groups was statistically significant(P<0.05).Conclusion:The operation of point ligation and suspension of hemorrhoid mucosa combined with Milligan-Morgan hemorrhoidectomy can safely and effectively treat the mixed hemorrhoids of grade III and IV internal hemorrhoids.On the basis of restoring the normal anatomical position of anal pad,the modified operation can also reduce postoperative complications,speed up the healing time,reduce the recurrence rate and realize individualized treatment.The patients are satisfied with it,which is worthy of clinical promotion.