不同浓度亚甲蓝对肛肠术后镇痛效果的比较研究

Clinical study of postoperative analgesic effect of methylene blue with different concentrations on anorectal surgery

目的观察不同浓度亚甲蓝对混合痔、肛瘘、肛裂、出口梗阻性便秘手术术后镇痛的效果。方法选择择期进行混合痔、肛瘘、肛裂、出口梗阻性便秘手术的患者120例,随机分为两组,每组60例。一组选用0.1%亚甲蓝(LM组);另一组选用0.05%亚甲蓝(RM组)。选用5号针头,将配好的不同浓度的亚甲蓝,分别在两组患者的手术创面注射10~15 ml。采用视觉模拟评分法(VAS)评价各组患者术后第3天、第6天、第9天、第12天、第15天疼痛情况。结果治疗后,两组患者术后VAS评分与本组治疗前相同时间点比较差异有统计学意义(P<0.05);两组患者术后第6天、第9天、第12天、第15天VAS评分比较差异有统计学意义(P<0.05)。结论0.1%亚甲蓝复合罗哌卡因对混合痔、肛瘘、肛裂、出口梗阻性便秘手术术后镇痛效果良好,安全可靠。

Objective To investigate the postoperative analgesic effect of different concentrations of methylene blue on hemorrhoids,anal fistula,anal fissure,and constipation of puborectal muscle syndrome surgery.Methods The 120 patients undergoing hemorrhoids,anal fistula,anal fissure,and constipation of puborectal muscle syndrome surgery were selected from our hospital and randomly divided into two groups,each with 60 patients.One group treated with 0.1%methylene blue(methylene blue 20 mg/2 ml+1% ropivacaine 10 ml+0.9% saline 8 ml,referred to as LM group);the other group treated with 0.05% methylene blue(methylene blue 10 mg/1 ml+1% ropivacaine 10 ml+0.9% saline 9 ml,referred to as RM group).0.1%or 0.05% methylene blue(10 ml to 15 ml)was injected into the surgical wounds of patients in two groups with a 5-gauge needle.Visual analogue scoring(VAS)was used to evaluate the pain at the 3 rd,6 th,9 th,12 th,and 15 th days after operation.Results After treatment,the difference in postoperative VAS scores of the two groups of patients was statistically significant compared with the same time point before treatment in this group(P<0.05);Statistical significance was found on day 6,9,12,and 15(P<0.05).Conclusions As for the postoperative effect,0.1% methylene blue combined with ropivacainewas better than 0.05%methylene blue combined with ropivacaine for mixed hemorrhoids,anal fistula,anal fissure,and outlet obstructive constipation after surgrey.