术前手法复位加长强穴封闭式局麻治疗嵌顿性内痔的疗效观察

Clinical observation on treating incarcerated hemorrhoids by preoperational manual reposition and Chang Qiang point closed local anaesthesia

目的:探讨术前手法复位加长强穴封闭式局麻对嵌顿性内痔手术疗效的影响。方法:将符合嵌顿性内痔诊断标准患者随机分为治疗组(A组):入院即予以手法复位及长强穴封闭式局麻,排除手术禁忌后次日安排手术;对照组(B组):入院予以抗感染、中药坐浴及50%硫酸镁溶液湿敷3～5d后安排手术,术后予以长强穴封闭式局麻。比较两组病人入院时及术前2h的肿、痛评分,术后第1、3、5、7d术后并发症(疼痛、水肿、便血)的评分,术后住院时间、创面愈合时间及皮赘残留程度。结果:上述观察指标,治疗组评分明显优于对照组(P<0.05),两组术后便血发生率无差异。结论:术前手法复位加长强穴封闭式局麻对提高嵌顿性内痔手术效果作用显著,减轻术后并发症,缩短治疗时间。

Objective： Discuss the surgical treatment effect on incarcerated hemorrhoids by the preoperational manual reposition and Changqiang points with close local anaesthesia. Method： Randomly divide patients with incarcerated hemorrhoids into two groups, namely （A） treated group and （B） control group. Patients in group A were given manual reposition and Changqiang point local anaesthesia after being hospitalized. They were operated the following day after ruling out operative taboos; Group B patients were given anti-infective therapy, TCM bath and wet dressing with 50% magnesium sulfate. They were operated 3 to 5 days after being hospitalized and were given Changqiang point local anaesthesia after operation. Rate and compare patients in two groups in terms of indexes like the degree of swelling and pain when hospitalized and 2 hours before operation, postoperative complications （the wound pain, edema and hematochezia） in l, 3, 5 and 7 days, hospital stays, the wound healing time and remaining wart. Results： Observation of indexed mentioned above indicates a significant outperformance in treated group （P〈0.05）. There is no significant difference in the occurrence rate of hematochezia between the two groups. Conclusion： Preoperative manual reposition and Changqiang point closed local anaesthesia can significantly improve operation results of incarcerated hemorrhoids. It also relieves postoperative complications and shortens hospital stays.