常规护理辅以PPH术前冷疗对Ⅲ～Ⅳ度混合痔患者的干预效果

The effect of routine nursing intervention adjuvant with preoperative cryotherapy for patients with mixed hemorrhoid of Ⅲ～Ⅳ degree undergoing PPH

目的常规护理辅以吻合器痔上黏膜环切术(procedure for prolapse and hemorrhoids,PPH)术前冷疗对Ⅲ~Ⅳ度混合痔患者的干预效果。方法选择2015年1月至2016年12月本院收治的120例Ⅲ~Ⅳ度混合痔患者为研究对象。随机分为对照组和观察组,每组各60例,对照组患者给予常规护理,观察组患者在对照组的基础上于PPH术前进行冷疗。比较两组患者手术相关指标、住院情况及术后情况。结果观察组手术时间为(15.36±1.87)min,术中出血2例(3.33%),住院时间为(5.28±1.49)d,住院费用为(4628.16±214.28)元,均少于对照组(均P<0.05)。观察组肛门水肿程度较轻,肛门水肿持续时间为(4.39±1.38)d,术后6 h疼痛评分为(4.17±1.28)分,均优于对照组(均P<0.05);两组患者术后24 h疼痛评分差异无统计学意义(P>0.05)。两组患者尿潴留和术后3个月痔复发脱出的发生率差异均无统计学意义(均P>0.05),术后出血情况差异无统计学意义(P>0.05)。结论在常规护理基础上辅以术前冷疗有助于缩短Ⅲ~Ⅳ度混合痔患者的PPH手术时间,降低术中出血发生率,利于减轻患者的疼痛感和肛门水肿程度。

Objective To investigate effect of routine nursing adjuvant with preoperative cryotherapy in the preoperative treatment of patients with mixed hemorrhoids of grade Ⅲ～Ⅳundergoing procedure for prolapse and hemorrhoids （PPH）. Methods 120 patients with grade Ⅲ～Ⅳ mixed hemorrhoids admitted to our hospital from January 2015 to December 2016 were selected as the research sub- jects. They were randomly assigned to control group and treatment group, with 60 cases in each group. The control group was given routine nursing care, and the treatment group was given additional preoperative eryotherapy. The operation related indices, hospitaliza- tion and postoperative condition were compared between the two groups. Results In the treatment group, the operation time was （15.36±1.87） min, the number of patients with bleeding was 2 （3.33%）, the hospitalization time was （5.28 ±1.49） d, the hospitaliza- tion expenses was （4628.16±214.28） Yuan. These indices were all better than those in the control group （all P 〈 0.05）. Severity of anal edema in the treatment group was less, and duration of edema was （4.39±1.38） d, postoperative 6 h pain score was （4.17±1.28） points, which were better than those in the control group （all P 〈 0.05 ）. There was no significant difference in pain score between two groups after 24 h （P 〉 0.05 ）. There was no significant difference between the two groups in the incidence of urinary retention and the recurrence of hemorrhoids after 3 months （all P 〉 0.05）. There was no significant difference in postoperative bleeding （P 〉 0.05）. Conclusion Routine nursing care with preoperative eryotherapy helps to reduce the time for PPH operation in patients with grade Ⅲ～Ⅳ mixed hemorrhoids. It reduces the incidence of intraoperative bleeding, patient＇s pain and risk of anal edema.