围产期妇女痔病的流行病学特征及个体化治疗分析

Epidemiological Characteristics and Individualized Treatment Analysis of Hemorrhoids in Perinatal Women

为探讨围产期妇女痔病的流行病学特征及个体化治疗效果,将240例围产期痔患者按随机数字表法分为观察组和对照组,各120例。均调查分析患者的流行病学特征,观察组给予地奥司明口服联合复方硝矾洗剂熏洗坐浴治疗,对照组给予地奥司明口服联合高锰酸钾溶液熏洗坐浴治疗。比较两组临床疗效、症状评分。结果显示,240例患者中混合痔为125例(52.08%)、血栓性外痔83例(34.58%)、内痔32例(13.33%),差异具有统计学意义(P<0.05);围产期妇女痔病的发生与年龄、孕期或产期、孕次、流产、分娩方式有关,差异有统计学意义(P<0.05);经多因素Logistic回归分析显示,孕期或产期、流产、分娩方式是围产期妇女痔病发生的重要危险因素(OR>1),年龄、孕次与围产期妇女痔病的发生无明确相关性(OR<1);观察组治疗总有效率为95.83%明显高于对照组的88.33%,差异有统计学意义(P<0.05);治疗后观察组便血、痔核脱出、肛门不适、肛周分泌物评分均低于对照组,差异有统计学意义(P<0.05)。结果表明,围产期妇女痔病以混合痔较为常见,年龄、孕期或产期、孕次、流产、分娩方式与围产期妇女痔病发生有关,其中孕期或产期、流产、分娩方式为其高危因素;给予患者复方硝矾洗剂熏洗坐浴治疗能有效减轻患者症状,提高临床疗效。

In order to study the epidemiological characteristics and individualized treatment effect of perinatal hemorrhoids,240 cases of perinatal hemorrhoids were randomly divided into observation group and control group,120 cases for each.The epidemiological characteristics of the patients were investigated and analyzed.The patients in the observation group were treated with diosmin orally combined with compound nitrate lotion fuming-wash sitz bath,and the patients in the control group were treated with diosmin orally combined with potassium permanganate solution fuming-wash sitz bath.The clinical efficacy and symptom scores were compared between the two groups.As results,125 cases(52.08%)were of mixed hemorrhoids,83 cases(34.58%)were of thrombotic external hemorrhoids and 32 cases(13.33%)were of internal hemorrhoids.The difference was statistically significant(P<0.05)The incidence of hemorrhoids in perinatal women was related to age,pregnancy or delivery period,the number of pregnancy,abortion and delivery mode,and the difference was statistically significant(P<0.05);pregnancy or delivery,abortion,delivery mode were important risk factors for the occurrence of hemorrhoids in perinatal women(OR>1),there is no clear correlation between age,pregnancy times and the occurrence of hemorrhoids in perinatal women(OR<1);The total effective rate of the observation group was significantly higher than that of the control group,the difference was statistically significant(95.83%vs 88.33%,P<0.05).The scores of hematochezia,hemorrhoid nucleus prolapse,anal discomfort and perianal secretion in the observation group after treatment were lower than those in the control group,and the difference was statistically significant(P<0.05).The results show that mixed hemorrhoids are more common in perinatal women.Age,pregnancy or delivery period,the number of pregnancy,abortion and delivery mode are related to the occurrence of hemorrhoids in perinatal women,the high risk factors are pregnancy or delivery period,abortion and delivery way;and compound nitrate lotion for fuming-wash sitz bath in the treatment of it could effectively relieve the symptoms of patients and improve the clinical effect.