脑压板在PPH术治疗Ⅱ～Ⅳ度非环状混合痔中的应用价值观察

Use of brain spatula in procedure for prolapse and hemorrhoids for grade Ⅱ～Ⅳ non-ring-shaped mixed hemorrhoids

目的探讨将脑压板应用于Ⅱ～Ⅳ度非环状混合痔PPH手术中的临床效果。方法选择2017年10月至2018年3月本科室收治的100例非环状混合痔患者为研究对象,随机将其分为观察组与对照组,每组各50例。观察组采用脑压板配合PPH手术治疗,对照组采用PPH手术治疗。比较两组临床疗效、手术相关指标、术后疼痛及并发症发生情况。结果两组总有效率均为100.00%。两组手术时间、术中出血量及住院天数比较,差异均无统计学意义(均P> 0.05)。观察组术后第3 d疼痛程度轻于对照组,差异有统计学意义(P <0.05);两组术后当天及术后第7 d疼痛程度比较,差异均无统计学意义(均P> 0.05)。观察组尿潴留、下腹部牵拉性疼痛发生率低于对照组,差异均有统计学意义(均P <0.05);两组继发性出血、肛缘水肿及吻合口狭窄发生率比较,差异均无统计学意义(均P> 0.05)。结论在PPH治疗Ⅱ～Ⅳ度非环状混合痔术中运用脑压板,经济简便,有助于减轻术后早期疼痛,具有一定的减少术后并发症的优势。

Objectives To investigate the effect of using brain spatula in procedure for prolapse and hemorrhoids(PPH)for gradeⅡ~Ⅳnon-ring-shaped mixed hemorrhoids.Methods One hundred patients with non-ring-shaped mixed hemorrhoids treated in our hospital between October 2017 and March 2018 were recruited as study subjects.They are randomly assigned to treatment group and control group,with 50 patients in each group.Patient in the treatment group received brain spatula during PPH and those in the control group received PPH only.Effectiveness,indices related to surgery,postoperative pain,and incidence of complications were compared between the two groups.Results Rate of effectiveness was 100.00%in both groups.There was no significant difference in duration of surgery,amount of intraoperative blood loss,and number of days of hospitalization between the two groups(P>0.05).Postoperative pain at the 3rd day was significantly lighter in the treatment group than in the control group(P<0.05),but pain at the operation day and the 7th day were similar between the two groups(P>0.05).Incidence of urinary retention and lower abdominal dragging was significantly lower in the treatment group than in the control group(both P<0.05),but the two groups were similar in terms of incidence of secondary hemorrhage,anal edema,and anastomotic stricture(P>0.05).Conclusion Using brain spatula in PPH in treating gradeⅡ~Ⅳnon-ring-shaped mixed hemorrhoids was an economic and user-friendly procedure.It could alleviate early postoperative pain and reduce,to a certain extent,risk of postoperative complications.