痔上黏膜环切术术后并发症66例临床分析及防治

CLINICAL ANALYSIS OF POSTOPERATIVE COMPLICATIONS OF 66 CASES OF HEMORRHOIDS MUCOSA LOOP ELECTROSURGICAL EXCISION PROCEDURE AND ITS PREVENTION

目的探讨痔上黏膜环切除术(PPH)术后并发症的发生情况及危险因素,指导临床术中、术后采取更为有效护理措施以减少其发生。方法回顾性分析66例行痔上黏膜环切除术后发生并发症患者的临床资料,总结患者在院期间的各种并发症的发生率,同时分析导致患者发生术后并发症的危险因素。结果所有并发症中,以术后出血发生率为最高57.58%,术后疼痛为24.24%,尿潴留为18.18%,吻合口感染为1.52%。同时经单因素及Logistic多因素分析显示,年龄≥60岁、合并糖尿病、存在术前焦虑及术前抑郁、围术期不当饮食及术后未康复锻炼均为导致患者术后并发症发生的危险因素(P<0.05),保持肛周清洁是导致患者术后并发症发生的保护因素(P<0.05)。结论 PPH术后并发症的发生与多种危险因素密切相关,临床护理中应注意对以上危险因素的预防。

Objective To analyze complications of hemorrhoid ring on mucosa resection surgery,and to discuss the risk factors of complications and guide clinical giving more effective care.Methods Retrospective analysis the clinical data of 66 patients with complications after procedures for prolapse and hemorrhoids.We investigated the complication rates of patients during hospital and analyzed the risk factors of postoperative complications.Results Postoperative bleeding had the highest incidence 57.58%,the incidence of postoperative urinary retention,anastomotic infection and postoperative pain was 18.18%,1.52% and24.24%,respectively.At the same time by univariate and multivariate logistic analysis showed that age≥60 years of age,hypertension,diabetes mellitus,preoperative anxiety,depression,preoperative and perioperative improper diet and no postoperative rehabilitation exercise for all cause postoperative complications in patients with risk factors（P〈0.05）and maintain clean of the anus was the protective factors（P〈0.05）.Conclusion Postoperative complications are closely associated with multiple risk factors;Clinical nursing should pay attention to the above risk factors for prevention.