改良外剥内扎术联合中药治疗老年混合痔

Clinical Observation of Improved Milligan-Morgan Hemorrhoidectomy combined with Traditional Chinese Medicine for Treatment of Elderly Mixed Hemorrhoids

目的:观察应用改良外剥内扎术联合中药内服治疗老年混合痔及术后并发症的疗效。方法:选取86例老年混合痔患者,以随机数字表法分为对照组与治疗组各43例。对照组采用传统外剥内扎术治疗,治疗组采用改良外剥内扎术联合中药内服治疗,术后均进行常规换药及护理干预。观察比较两组有效率、术后并发症、肛肠动力指标等。结果:治疗组有效率为83.72%,明显高于对照组(74.42%,P<0.01);治疗2个月后治疗组肛管静息压及肛管最大收缩压分别为(31.93±3.38)kPa、(121.74±10.42) kPa,均低于对照组[分别为(54.33±4.76) kPa、(138.71±9.13) kPa,P<0.01)],治疗组术后并发症发生率为23.26%,较对照组明显减低(62.79%,P<0.01)。结论:改良外剥内扎术联合中药内服,可明显改善老年混合痔患者临床症状,减少术后并发症的发生。

Objective To observe the efficacy of improved Milligan-Morgan hemorrhoidectomy combined with traditional Chinese medicine in the treatment of elderly mixed hemorrhoids and its postoperative complications. Methods Eighty-six elderly patients with mixed hemorrhoids were enrolled. The patients were divided into control group and treatment group （n=43）. The patients in control group were treated with traditional Milligan-Morgan hemorrhoidectomy. The patients in treatment group were treated with improved Milligan- Morgan hemorrhoidectomy combined with traditional Chinese medicine. The patients were treated with routine dressing and nursing intervention. The efficiency, postoperative complications and anorectal dynamics in the two groups were observed and compared. Results The effective rate of the treatment group was 83.72%, which was significantly higher than that of the control group （74.42%） （P〈0.01 ）. After 2 months of treatment, the anal canal resting pressure and the maximum systolic pressure of the anal canal were （31.93 ＋ 3.38） kPa and （121.74 ＋ 10.42） kPa, which were lower than those in the control group [（54.33 ＋ 4.76） kPa and （138.71 ＋ 9.13） kPa] （P〈0.01）. The postoperative complication rate of the treatment group was 23.26%, which was significantly lower than that of the control group （62.79%） （P〈0.01）. Conclusion Improved Milligan-Morgan hemorrhoidectomy combined with traditional Chinese medicine can significantly improve the clinical symptoms of elderly patients with mixed hemorrhoids and reduce the incidence of postoperative complications.