【摘 要】 目的 观察将痔上黏膜环切除术(PPH)与传统术式相结合治疗有明显外痔的重度混合痔的临床疗效。方法 先用电刀将外痔部分切除后，将肛管皮肤与肛缘皮肤对合缝合，重建肛管，再行PPH。结果 采用本法治疗32例患者，术后无1例出血，术后感觉疼痛需肌肉注射止痛药者10例，无需止痛药22例，尿潴留需导尿者11例。术后第1日全部可下床活动，平均住院时间3.9日，无1例发生大便失禁、肛门狭窄、感染或肛周脓肿形成。结论 PPH结合外痔切除肛管重建术治疗有明显外痔的重度混合痔，具有术后疼痛轻、并发症少、恢复快、疗效好等优点。

    【关键词】 PPH；外痔；肛管重建；重度混合痔

    Clinical observation of combination of PPH with external hemorrhoid incision and anal canal reconstruction on 32 patients with severe mixed hemorrhoid ZHENG Shaokang, DU Gangyi. Department of Anointestinology, TCM Hospital, Zhongshan, Guangdong, Zhongshan 528400

    【Abstracts】 Objective To observe the clinical effect of combination of PPH with external hemorrhoid incision and anal canal reconstruction on patients with severe mixed hemorrhoid.Methods Patents with severe mixed hemorrhoid were incised part of the external hemorrhoid with electric knife and sutured the skin of anal canal with the limb of the anal for the reconstruction of anal canal. After that patients were undergone PPH.Results There was no patient having hemotachezia.10 patients needed to inject alnalgetic. 11 patients suffered from urinary retention. All the patients could do mild activity freely the first day after operation. The mean admission time was 3.9 days. There was no fecal incontinence, anal stenosis, infection and perianal abscess information observed.Conclusion Combination of PPH with external hemorrhoid incision and anal canal reconstruction can relieve pain after operation with few complications. ......