乳果糖口服溶液防治混合痔外剥内扎术后并发症疗效观察

Observation on the Clinical Efficacy of Lactulose Oral Solution in the Prevention and Treatment of Postoperative Complications of Mixed Hemorrhoid Milligan-Morgan

目的探讨乳果糖口服溶液防治混合痔外剥内扎术后并发症的临床疗效。方法将2013年1月—2017年1月瓦房店妇婴医院肛肠科收治的80例混合痔患者按照随机数表法随机分为治疗组(40例)与对照组(40例),其中治疗组患者于混合痔外剥内扎术后预防性应用乳果糖口服溶液,对照组患者于混合痔外剥内扎术后前两天不予以任何通便药物治疗,术后第3天给予仍未排便且有粪便蓄积的患者开塞露灌肠治疗。对比观察两组患者的术后排便及疼痛等情况。结果混合痔外剥内扎术后,治疗组患者中出现排便困难者10例,排便疼痛<2分者30例,出现粪便嵌塞者2例;对照组患者中出现排便困难者28例,排便疼痛<2分者15例,出现粪便嵌塞者16例。两组患者出现排便困难例数、排便疼痛<2分例数及出现粪便嵌塞例数对比采用四格表资料的卡方检验,χ~2值分别为16.241、11.429及14.050,P值均为0.000,P均<0.01,差异具有统计学意义。结论混合痔外剥内扎术后预防性应用乳果糖口服溶液,可有效避免大便干燥,促进排便,缓解因排便困难而导致的疼痛,降低粪便嵌塞的发生率,疗效显著,值得临床推广应用。

Objective To investigate the clinical efficacy of Lactulose oral solution in the prevention and treatment of postoperative complications of mixed hemorrhoid Milligan-Morgan. Methods Eighty patients with mixed hemorrhoid admitted into the Proctology Department of Wafangdian Women and Infants Hospital between January of 2013 and January of 2017 were randomly divided into an experiment group（40 cases） and a control group（40 cases） according to the random number table,of which patients in the experiment group were given Lactulose oral solution prophylactically after the Milligan-Morgan while patients in the control group were not given any laxatives to help defecation on the first two days post operation and glycerine enema was only given to those who didn＇t defecate and suffered fecal accumulation on the third day post operation. Postoperative defecation condition and defecation pain were observed and compared between the two groups.Results After the mixed hemorrhoid Milligan-Morgan,the experiment group observed defecation difficulty in 10 cases,defecation pain 2 scores in 30 cases and fecal impaction in 2 cases while in the control group,defecation difficulty in 28 cases,defecation pain 2 scores in 15 cases and fecal impaction in 16 cases. The Chi-square test of fourfold table was used for the comparison of number of cases developing defecation difficulty,defecation pain 2 scores and fecal impaction,and the results showed statistically significant difference,χ~2= 16. 241,11. 429 and 14. 050 respectively,all P = 0. 000,all P〈0. 01. Conclusion The prophylactical application of lactulose oral solution after the mixed hemorrhoid Milligan-Morgan can effectively prevent dry stool,promote defecation,relieve pain resulting from defecation difficulty and significantly decrease the incidence of postoperative complications such as defecation difficulty,defecation pain and fecal impaction,deserving to be promoted in clinical practice.