提肛运动在痔吻合器痔上黏膜环切术术后肛门坠胀治疗中的作用

Effect of levator ani movement in postoperative anus belly after PPH

目的探讨适宜的提肛运动在痔吻合器痔上黏膜环切术（PPH）术后肛门坠胀治疗中的作用，为更好地提高PPH患者的生活质量提供参考。方法选取2011年10月～2013年10月在诸城市中医院确诊为混合痔Ⅲ、Ⅳ度，且因行PPH术而出现肛门坠胀患者200例，随机将其分为两组，观察组100例，对照组100例，两组患者入院后第5天起行手术治疗，对照组给予术后常规抗生素抗感染治疗；观察组患者于术后常规治疗并于第3天行提肛运动。3个月后对患者行指标观察，包括患者出现肛门坠胀的时间、肛门坠胀程度、坠胀持续时间、控便能力及急便感。结果两组坠胀持续时间评分、坠胀程度评分均较治疗前显著下降，差异有统计学意义（P〈0．01或P〈0．05），其中观察组的评分改善更明显（P〈0．01），且治疗后观察组坠胀持续时间评分、坠胀程度评分[（0．04＋0．01）、（0．08±0．03）分]明显低于对照组[（1．20±0．74）、（0．98±0．40）分]，差异有统计学意义（P〈0．05）。两组消除肛门坠胀时间比较，观察组[（3．50±1．14）d]明显较对照组[（5．55±1．01）d]缩短，差异有高度统计学意义（P〈0．01），急便感评分、控便能力评分降低[（0．14±0．01）分比（0．37±0．02）分，（0．10±0．00）分比（0．46±0．11）分]，差异有统计学意义（P〈0．01或P〈0．05）。结论适宜的提肛运动对PPH术后肛门坠胀患者作用较为明显，能有效减轻肛门坠胀，缩短坠胀时间，减轻PPH术后肛门坠胀对患者引起的不适，提高患者生活质量及满意度。

Objective To study the effect of appropriate levator ani movement for postoperative anus belly after PPH, in order to provide reference to improve the quality of life of patients with PPH. Methods 200 patients with postoperative anus belly after PPH, diagnosed mixed hemorrhoid l]I, IV degrees, in Traditional Chinese Medicine Hospital of Zhucheng City from October 2011 to October 2013 were chosen and randomly divided into two groups, observation group （100 cases）, control group （100 cases）, and two groups were given the surgery after 5 days in hospital. The con- trol group was given conventional antibiotic resistance to infection after surgery, and the observation group was given the conventional treatment and levator ani movement at 3rd after surgery. After 3 months, the indicators including the anal belly time, the degree of anus belly, belly duration, control defecation ability and fecal urgency were observed. Results Both two groups, the belly duration, the degree of anus belly score were more decreased than those before treatment, the differences were statistically significant （P 〈 0.01 or P 〈 0.05）, and those of observation group improved more significantly than control group （P 〈 0.01）, and the degree of anus belly score of observation group after treatment [（0.04±0.01）, （0.08±0.03） scores] were lower than those of control group [（1.20±0.74）, （0.98±0.40） scores], the differ- ences were statistically significant （P 〈 0.05）. The time of eliminated anus belly of observation group [（3.50±1.14） d] was obviously lower than that of control group [（5.55±1.01） d], the differences was statistically significant （P 〈 0.01）, fecal urgency score and control defecation ability score observation were lower than those of of control group [（0.14± 0.01） scores vs （0.37±0.02） scores, （0.10±0.00） scores vs （0.46±0.11） scores], the differences were statistically signifi- cant （P 〈 0.01 or P 〈 0.05）. Conclusion The appropriate levator ani movement is more obvious at patients with postop- erative anus belly after PPH, it can effectively reduce the anus belly, shorten the time of anus belly, reduce the postop- erative anal belly PPH discomfort, improve patients＂ quality of life and satisfaction.