局麻联合镇静药物行PPH术治疗Ⅲ、Ⅳ度痔112例临床分析

The clinical analysis of PPH in the treatment of 112 cases of Grade Ⅲ,Ⅳ hemorrhoids under local anesthesia supplemented with sedation

目的:评估局麻联合镇静药物作用下行痔上粘膜环切术(Procedure for prolapsing hemorrhoids,PPH)的可行性。方法:112例Ⅲ、Ⅳ期的内痔或混合痔患者在鲁米那+海俄辛+1.0%利多卡因局麻下行PPH术,在对术中、术后疼痛、尿潴留、出血、返回工作时间、住院费用等进行调查。结果:112例病人均顺利完成手术,术中无需转其它麻醉方式;术后肛周疼痛需镇痛药者42例;尿潴留者7例;9例患者有腹胀不适或肛内坠胀感;3例出现肛周水肿;1例出现肛门控便能力下降(表现为大便污裤),平均住院费用为(4537±364)元。结论:应用局麻联合镇静药物作用下行PPH术是一种安全可行的手术方法,可减少术后尿潴留的发生并且可减少费用。

Objective：This prospective study was designed to assess the feasibility of performing the procedure for prolap- sing hemorrhoids（PPH） under local anesthesia supplemented with sedation. Methods： 112 patients with Grade 3 or 4 hemorrhoids underwent the PPH after perianal in/ihration of 1.0 percent lidoeaine and luminal and hyoseine. We carried out an investigation for degree of intra/postoperative pain, urinary retention, bleeding, and the time back to work and cost. Result：All patients accomplished the operation without transferring other anesthesia . Forty-two patients appeared postoperative perianal pain and required analgesics; seven patients were in urinary retention; nine patients complained of perineal pressure; three patients appeared perianal oedema and one complained of fecal urgency; the mean cost is （4537 ±364） yuan. Conclusion： The use of local anesthesia supplemented with sedation for PPH is a feasible and safe way, it can reduce the frequency of urinary retention and cost.