Abstract
目的 比较吻合器痔上黏膜环形切除术( PPH)与 Milligan-Morgan术( MMH)的安全性和有效性.方法 共检索出符合入选标准的随机对照临床实验 10项,采用固定效应模型和随机效应模型对 PPH与 MMH的安全性和有效性指标进行 Meta分析.结果与 MMH相比,PPH在缩短手术时间和住院时间、减轻术后疼痛、肛门分泌物、患者满意度等有效性方面有一定优势;但术后残留皮赘和痔脱垂复发更为常见.在术后出血、尿潴留、排便困难、肛裂、肛门狭窄、内括约肌损伤、正常活动的恢复、肛门失禁和瘙痒、肛管静息压和收缩压变化及镇痛的需求方面未见明显优势.结论 PPH至少和 MMH一样安全.其有效性仍需有长期随访的更大宗病例研究进一步证实。
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