不同镇痛方法对环状混合痔术后并发症的影响

The Impact of Different Methods of Analgesia on the Postoperative Complications of Circumferential Mixed Hemorrhoids

为分析研究临床不同镇痛方法对环状混合痔术后并发症的影响，探求环状混合痔术后有效镇痛方法，将90例环状混合痔术后患者按镇痛方法的不同分为3组，每组各30例，A组采用帕瑞昔布加亚甲蓝加太宁软膏进行镇痛，B组采用亚甲蓝镇痛，C组采用太宁软膏镇痛。对3组患者的疼痛、出血、水肿、尿潴留等并发症进行统计学分析，并对环状混合痔术后并发症的原因进行分析，同时对同组患者使用镇痛药物和停药后并发症的程度进行比较。结果显示，3组患者在疼痛、出血、水肿、尿潴留等并发症方面有显著性差异（P〈0．05）。A组患者综合使用多模式镇痛和超前镇痛，有效地缓解了水肿、出血、尿潴留等并发症，具有良好的镇痛效果。停药后患者的肛门括约肌痉挛程度轻，并发症得到明显的缓解，症状基本消失，与用药前比较有显著性差异（P〈0．05）。结果表明，环状混合痔术后并发症勺括约肌痉挛有关，超前镇痛加多模式镇痛在减轻并发症方面均有明显优势。

This paper was to discuss the impact of different methods of analgesia on the postoperative complications of circumferential mixed hemorrhoids, so as to find an effective analgesic method. Ninety patients were divided into three groups according to different analgesic methods,30 for each. For analgesia,group A received parecoxib,methylene blue plus compound carraghenates suppository; group B methylene blue; and group C compound carraghenates suppository. Data on pain, bleeding, edema, urinary retention and other complications were processed statistically in the three groups, and the causes of postoperative complications were analyzed. Meanwhile, the extent of complications was compared before and after treatment with analgesics in the each group. The results showed that significant difference was found among the three groups in pain,bleeding, edema, urinary retention and other complications （ P〈 0. 05）. In group A, integrated multi-modal analgesia and preemptive analgesia could effectively reduce complications such as edema, bleeding and urinary retention, and showed a better analgesic efficacy. After withdrawal of analgesia, the patients demonstrated mild anal sphincter spasm, complications were obviously improved and symptoms almost disappeared,which was significantly different from the condition before treatment （ P 〈0.05）. It is concluded that postoperative complications of circumferential mixed hemorrhoids are associated with sphincter spasm,preemptive analgesia and integrated multi-modal analgesia have obvious advantages to reduce complications.