| Objective: To explore the influence factors of wound healing,anal function and recurrence rate in patients with moderate and severe anemia mixed hemorrhoids treated by PPH surgery.Methods: A total of 148 patients with moderate to severe anemia mixed hemorrhoids(internal hemorrhoids III～IV)hospitalized in the proctology department of Longhua District People’s Hospital of Shenzhen City from April 1,2020 to March 31,2022 were recruited as clinical subjects,including 86 males and 62 females,with an average age of 39.37±7.55 years.Patients were randomly divided into control group(n=74)and observation group(n=74)to receive traditional exfoliation and internal ligation.The study was approved by the hospital’s ethics committee,and all patients provided written informed consent.General data of patients were collected.The intraoperative operation time,intraoperative blood loss and length of hospital stay of the two groups were counted.Patients,wound bleeding 48 hours after surgery,and wound edge edema on the 5th day after surgery were compared.Wound healing was compared 1 month after operation.Anal function was compared 3 months after operation.Anal Wexner score and VAS score were compared 3 months after operation.The therapeutic effect of the two groups was compared.The postoperative complications and recurrence rate were analyzed.Single Logistic regression was used to analyze the risk factors of postoperative recurrence of PPH.Patients’ satisfaction scores were compared 1 month,3months and 6 months after surgery.Results: There were no differences in age,sex,BMI,degree of anemia,stage of internal hemorrhoids,smoking and drinking habits between the two groups(P>0.05).Operation time,intraoperative blood loss and length of stay in the observation group were reduced compared with the control group(P<0.05).The defecation bleeding score of the observation group was lower than that of the control group 48 hours after operation(P<0.05).The wound edge edema score of the observation group was lower than that of the control group on the 5th day after surgery(P<0.05).The wound healing score of the observation group was lower than that of the control group 1 month after surgery(P<0.05).The maximum systolic pressure and resting pressure of anal canal in the observation group were higher than those in the control group(P<0.05),while the anal morphological scores in the observation group were lower than those in the control group(P<0.05).Anal Wexner score and VAS score in the observation group were lower than those in the control group(P<0.05).The effective rate of the observation group was higher than that of the control group(P<0.05).The recurrence rate of the observation group was lower than that of the control group(P<0.05).Consumption of pure milk,sweet food,spicy food,family genetic history,sedentary inactivity,poor postoperative care and chronic constipation were the influencing factors for postoperative recurrence of PPH(P<0.05).There was no difference in the satisfaction score between the two groups 1 month after surgery(P>0.05).3 months and 6months after surgery,the satisfaction score of the observation group was higher than that of the control group(P<0.05).Conclusion: PPH is the best treatment method for mixed hemorrhoids with moderate and severe anemia.This method can effectively remove hemorrhoids and improve anal function while preserving the anatomy and physiology of the anal canal.In addition,this procedure overcomes the shortcomings of traditional surgery,reduces postoperative pain,edema,anal stenosis and other complications,reduces wound healing time,promotes wound healing,and improves surgical quality.It is a valuable method for treating annular mixed hemorrhoids,and can be widely used in clinical practice.In addition,the recurrence of hemorrhoids after PPH is related to a variety of factors.Healthy and reasonable diet and living habits are important measures to prevent postoperative recurrence,especially for those with a family history of hemorrhoids. |
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