TST术与M-M术治疗痔的疗效比较及护理策略研究

Clinical efficacy of tissue selecting technique compared with Milligan – Morgan hemorrhoidectomy in hemorrhoids treatment and study of nursing trategy

目的比较开环式微创痔上黏膜切除吻合术（TST术）与外剥内扎术（M-M术）治疗痔的临床疗效,并总结护理方法。方法选取62例痔疮患者,按手术方式分为2组,观察组（35例）行TST术,对照组（27例）实施M-M。术后结合患者实际情况给予辅助性治疗及术后定期随访。记录2组患者术后疼痛评分、痊愈时间以及并发症情况。结果观察组术后12 h、1-7 d的疼痛评分及术后愈合时间等指标明显优于对照组,差异具有统计学差异（P〈0.05）。而术后1个月的疼痛评分,术后出血、感染、肛门直肠狭窄、尿储留等并发症的比较,2组差异无统计学意义（P〉0.05）。结论 TST术与传统的M-M术式相比,TST术疼痛轻微,术后恢复快,术后并发症少。TST术后的护理重点为疼痛、出血、感染及尿储留。

Objective To comparative analyze the clinical efficacy and application value of Tissue selecting technique and Milligan –Morgan hemorrhoidectomy in the treatment of hemorrhoid. Methods Totally 62 cases with hemorrhoids were reviewed retrospectively. According to different surgery method,we divided them into two groups,with 35 Tissue selecting technique（ observation group）,27 Milligan – Morgan hemorrhoidectomy（ control group）. Postoperative parameters in both groups were collected and compared. Results The postoperative pain score at 12 h,day1,day2,day 3,day 7 and postoperative healing time were significantly better in the TST group than that in the MMH group（ P〈0. 05）. While there is no significant difference between two groups in postoperative pain score after 1 month,postoperative hemorrhage,infection,anorectal stenosis and urinary retentron.（ P〉0. 05）. Conclusion The Tissue selecting technique was superior to Milligan – Morgan hemorrhoidectomy with slighter pain,quicker postoperative recovery and less complications. The emphasis of nursing for patients after Tissue selecting technique mainly focus on postoperative pain,hemorrhage,infection and urinary retentron.