高悬低切术对混合痔患者术后疼痛的影响

Effect of High-hanging and Low-cutting Surgery on Postoperative Pain of Patients with Mixed Hemorrhoids

目的观察高悬低切术改善患者术后疼痛的临床疗效。方法将86例混合痔患者随机分为高悬低切组(观察组)和外剥内扎组(对照组),每组43例。两组患者术后均常规静脉滴注止痛药物3日;每日中药坐浴2次,每日伤口换药1次,连续1周。观察术后8h、24h、48h、72h、首次排便后患者疼痛评分,术前及术中外痔处理数量,术后4周评价患者满意度。结果与对照组比较,观察组术后8h、24h、72h、首次排便后的疼痛评分降低(P<0.05),术中处理外痔数量减少(P<0.05),患者满意度差异无统计学意义(P>0.05)。结论高悬低切术式能减少对肛管部分的损伤,减少术中外痔处理数量,明显缓解术后疼痛,患者术后满意度高。

Objective To observe the clinical effect of high-hanging and low-cutting surgery on postoperative pain of mixed hemorrhoids. Methods Totally 86 cases of mixed hemorrhoids were ran- domly assigned to high-hanging and low-cutting group （observation group） and Milligan Morgan group （control group）,43 cases in each group. All patients received intravenous dripping of painkillers for 3 days, hip bathing with Chinese medicine twice a day, and exchanged once a day after surgery ,the treat- ment lasted for 1 week.The pain scores in 8 h, 24 h, 48 h, 72 h and at the first defecation after surgery were measured. The number of external hemorrhoids was counted before and during surgery. The patient satisfaction was evaluated at 4 weeks post-surgery. Results Compared with the control group, the pain scores of the observation group decreased in postoperative 8 h, 24 h, 72 h and the first defecation （P 〈 0.05） ; the number of external hemorrhoids during surgery decreased（ P 〈0.05）. But for index of satis- faction, no significant difference was found （P 〉0.05）. Conclusion High-hanging and low-cutting sur- gery can reduce the injury of anal canal and the number of external hemorrhoids, and alleviate postoper- ative pain with high satisfaction.