Efficacy Of Improved And Traditional External Dissection And Internal Ligation For Circumferencial Mixed Hemorrhoid

Objective: As one of the common anorectal diseases,circumferencial mixed hemorrhoid usually uses within traditional and improved external dissection and internal ligation surgery to treat in the clinical.Due to the treatment of effect is jagged,circumferencial mixed hemorrhoid has always been one of the hot spot of clinical research.Therefore,how to select the best procedure and maximize the removal of patients' symptoms,protect anal function,decrease the occurrence of postoperative complications,has became a big difficulty in the clinical treatment of circumferential mixed hemorrhoid.Different kinds of operation methods will be used to study and evaluate the clinical effect of the improved external dissection and internal ligation for circumferencial mixed hemorrhoid.We will compare from the clinical effect,postoperative complications,hospitalization time,cost and symptom score of the visual analogue scale(VAS score)at postoperative 6h,12 h,24h.Methods: The 60 hospitalized patients eligible for circumferential mixed hemorrhoid between March 2014 and October 2015 from the feng yi gang tai hospital of Shijiazhuang,were randomly divided into the observation group and the control group by the method of digits table,each group included 30 cases.After inspection,the two groups in age,the disease duration,lesions classification and the past medical history,had no significant difference,P>0.05.Patients in the observation group received the treatment of the improved external dissection and internal ligation for circumferencial mixed hemorrhoid.Patients in the control group received the treatment of the traditional external dissection and internal ligation for circumferencial mixed hemorrhoid.The treatment effect of the two group was observed and analysed,mainly from the clinical curative effect,postoperative complications(postoperative edema,postoperative urine retention,postoperative tenesmus swells and anal stenosis),the hospitalization time and cost,and symptom score of the visual analogue scale(VAS score)at postoperative 6h,12 h,24h.Result:1 The comparison of the two groups in the Clinical general informationGender,the observation group : male 18 cases,female 12 cases;the control group: male 16 cases,female 14 cases;Average age:the observation group is 37.26± 6.86 years old,and the control group is 40.94±5.07 years old;Average duration:the observation group is 7.35±1.61 years,and the control group is 6.94±1.47 years;Lesions classification:the observation group consists of phase III hemorrhoids(19 cases)and phase IV hemorrhoids(11 cases),and the control group consists of phase III hemorrhoids(21 cases)and phase IV hemorrhoids(9 cases).Compared with the two groups in the Clinical general information,They had no significant difference,P>0.05.2 The comparison of the two groups in the clinical curative effect(the overall efficiency)at 4 weeks after surgeryIn the observation group,the number of clinical recovery is 25 cases,improved is 5 cases,invalid is 0 case,the total effective rate of the observation group is 100%.In the control group,the number of clinical recovery is 22 cases,improved is 8 cases,invalid is 0 case,the total effective rate of the control group is 100%.The two groups had no significant difference.P>0.05.3 The comparison of the two groups in postoperative complicationspostoperative edema: the observation group includes 3 cases,the control group includes 7 cases.postoperative urine retention: the observation group includes 2 cases,the control group includes 6 cases.Postoperative tenesmus swells: the observation group includes 2 cases,the control group includes 2 cases.Postoperative anal stenosis:the observation group includes 0 case,the control group includes 1 case.In postoperative edema,postoperative urine retention,the observation group was compared with the control group,P<0.05.They had significant difference.In other ways,the two groups had no significant difference,P>0.05.In overall incidence of adverse reactions,the observation group was significantly lower than that of the control group.They had significant difference.P<0.05.4 The comparison of the two groups in hospitalization time and costThe hospitalization time in the observation group is 15.12±3.56 days,in the control group is 24.37±4.19 days.The hospitalization cost in the observation group is 8547.32±537.04 yuan,in the control group is 11527.83±473.26 yuan.The two groups had significant difference,P<0.05.5 The comparison of the two groups in symptom score of postoperative painThe symptom score of the two groups: the observation group :at 6 hours after surgery,the symptom score is 1.82±0.33;at 12 hours after surgery,the symptom score is 4.30±1.17;at 24 hours after surgery,the symptom score is 3.28±0.93.The control group : at 6 hours after surgery,the symptom score is 1.91±0.26;at 12 hours after surgery,the symptom score is 6.41±1.23;at 24 hours after surgery,the symptom score is 5.32±1.09.Compared with the two groups at 6 hours after surgery,they had no significant difference.P>0.05.At 12 and 24 hours after surgery,they had significant difference,P<0.05.Conclusion: The improved external dissection and internal ligation for circumferencial mixed hemorrhoid can effectively improve the patients' symptoms in hemorrhoids prolapse.In the incidence of postoperative complications,this surgery was lower than the traditional external dissection and internal ligation for circumferencial mixed hemorrhoid.And this surgery has the advantages of easy operation,safety,low cost and shorter hospitalization time.What's more,this surgery reduces the patients' pain and economic burden.So it is worthy of further clinical application.