三联疗法对痔疮术后并发症和创面愈合的影响

Effects of Triple Therapy on Postoperative Complications and Wound Healing of Hemorrhoids

目的:探讨"洗、吹、塞"三联疗法对痔疮术后并发症和创面愈合的影响。方法:选取2016—2018年张家口市第五医院收治的拟行手术治疗的痔疮患者210例,以随机数字表法分为观察组和对照组,每组105例。对照组患者术后第2日给予单纯便后盐水冲洗擦干;观察组患者术后第2日开始给予中药煎剂外洗、棉布蘸净,吹风机吹干、复方角菜酸酯栓塞肛。两组患者均采用医用脱脂棉夹于两臀部之间,并及时更换。给药7 d后,比较两组患者的临床疗效,肛门疼痛、肛缘水肿及切口感染情况,创面愈合时间和并发症发生情况的差异。结果:观察组患者的总有效率为100.00%(105/105),明显高于对照组的84.76%(89/105),差异有统计学意义(P<0.05);术后5、7 d时,观察组患者的疼痛视觉模拟评分明显低于对照组,差异均有统计学意义(P<0.05);术后3、5及7 d时,观察组患者的肛缘水肿评分明显低于对照组,差异均有统计学意义(P<0.05);观察组患者的切口感染率为8.57%(9/105),明显低于对照组的18.10%(19/105),差异有统计学意义(P<0.05);观察组患者术后创面愈合时间明显短于对照组,尿潴留、出血发生率明显低于对照组,差异均有统计学意义(P<0.05)。结论:"洗、吹、塞"三联疗法能有效减轻患者痔疮术后疼痛、水肿情况,降低术后切口感染、尿潴留和出血的发生率,促进创面愈合。

OBJECTIVE:To explore the effects of triple therapy of “washing,blowing and plugging” on postoperative complications and wound healing of hemorrhoids.METHODS:Totally 210 patients with hemorrhoids undergoing surgical treatment in Zhangjiakou the Fifth Hospital from 2016 to 2018 were extracted to be divided into the observation group and the control group via the random number table,with 105 cases in each group.Patients in the control group were given saline irrigation and drying on the 2nd day after surgery,and the observation group received traditional Chinese medicine decoction for external washing,cotton cloth for cleaning,hair dryer for drying,and compound carrera acid ester for anal embolization.Two groups were treated with medical absorbent cotton between the buttocks,and timely replacement was conducted.After 7 d of administration,the clinical efficacy,anal pain,anal edema,wound infection,wound healing time and complications were compared between two groups.RESULTS:The total effective rate in the observation group was 100.00%(105/105),significantly higher than that in the control group 84.76%(89/105),with statistically significant difference ( P <0.05).At 5 and 7 d after surgery,the visual simulation scores of the observation group were significantly lower than those of the control group,and the differences were statistically significant ( P <0.05).At 3,5 and 7 d after surgery,the scores of anal edema in the observation group were significantly lower than those in the control group ( P <0.05).The incisional infection rate in the observation group was 8.57%(9/105),significantly lower than that in the control group 18.10%(19/105),and the difference was statistically significant ( P <0.05).The wound healing time was significantly shorter in the observation group than in the control group,and the incidence of urinary retention and bleeding was significantly lower in the observation group than in the control group,with statistically significant differences ( P <0.05).CONCLUSIONS:The triple therapy of “washing,blowing and plugging” can effectively reduce the postoperative pain and edema of patients with hemorrhoids,reduce the incidence of postoperative wound infection,urinary retention and bleeding and promote the wound healing.