糜蛋白酶对肛肠术后伤口愈合和营养状态的临床疗效

Clinical effects of chymotrypsin on wound healing and nutritional status in patients after anorectal surgery

目的:探讨糜蛋白酶对肛肠术后伤口愈合和营养状态的临床疗效.方法:2012-01/2014-02在嵊州市人民医院外三科接受肛肠术的120例患者为研究对象,随机分为两组,分别进行糜蛋白酶治疗(治疗组)和常规治疗(对照组).比较两组疗效、伤口愈合率、平均愈合时间及营养状态.结果:治疗组60例,显效36例(60.00%),有效22例(36.67%),无效2例(3.33%),总有效率为96.67%;治疗组60例,显效13例(21.67%),有效28例(46.67%),无效19例(31.67%),总有效率为68.33%.两组疗效比较,差异具有统计学意义(P<0.05).治疗组术后1、2 w k、1 m o的伤口愈合率分别为22.37%±2.54%、83.56%±5.78%、95.72%±4.19%,平均愈合时间为16.27 d±3.24 d;对照组术后1、2 wk、1 mo的伤口愈合率分别为13.96%±1.73%、42.36%±4.91%、61.55%±3.82%,平均愈合时间为22.56 d±2.73 d.两组伤口愈合率及平均愈合时间比较,差异具有统计学意义(P<0.05).术前1 d,两组总蛋白、血红蛋白、前白蛋白及白蛋白比较,差异不具有统计学意义(P>0.05).术后2 wk,治疗组总蛋白、血红蛋白、前白蛋白及白蛋白均明显高于对照组,且处于正常水平.结论:糜蛋白酶能够促进肛肠术后伤口愈合,改善患者营养状态,值得临床推广.

AIM：To evaluate the clinical effects of chymotrypsin on wound healing and nutritional status in patients after anorectal surgery.METHODS：One hundred and twenty patients who underwent anorectal surgery from January 2012 to February 2014 at Shengzhou People＇s Hospital were randomly divided into two groups to receive either chymotrypsin treatment（treatment group） or conventional treatment（control group）.The rate of wound healing,the average healing time and nutritional status were compared for the two groups.RESULTS：In the treatment group,there were36（60.00%） cases of complete response（CR）,22（36.67%） cases of partial response（PR）,and 2（3.33%） cases of non-responsiveness,and the total response rate was 96.67%.In the control group,there were 13（21.67%） cases of CR,28（46.67%） cases of PR,and 19（31.67%）cases of non-responsiveness,and the total response rate was 68.33%.The total response rate was significantly higher in the treatment group（P〈0.05）.In the treatment group,the rates of wound healing at 1,2 wk,and 1 mo were 22.37%± 2.54%,83.56%± 5.78%,95.72%± 4.19%,respectively,and the average healing time was 16.27 d ± 3.24 d;the corresponding vales in the control group were 13.96%± 1.73%,42.36%± 4.91%,61.55%± 3.82%,and 22.56 d ±2.73 d.The wound healing rates and average healing time differed significantly between the two groups（P〈0.05）.Preoperatively,total protein,hemoglobin,albumin and prealbumin were not significantly different between the two group（P〉0.05）;however,the total protein,hemoglobin,prealbumin and albumin were significantly higher in the treatment group at 2 wk postoperatively.CONCLUSION：Chymotrypsin can promote wound healing and improve nutritional status in patients after anorectal surgery.