吻合器痔上黏膜环切术配合中药坐浴治疗Ⅱ~Ⅳ度痔疮疗效观察

Observation of curative effect of circumcision of prolapse and hemorrhoids with stapler combined with traditional Chinese medicine sitz bath in the treatment of Ⅱ~Ⅳ degree hemorrhoids

目的探究吻合器痔上黏膜环切术配合中药坐浴治疗Ⅱ~Ⅳ度痔疮的临床疗效。方法选择2017年7月至2019年12月于本院进行手术治疗的Ⅱ~Ⅳ度痔疮患者60例,采用随机数字表法分为两组各30例。对照组行外剥内扎术,研究组采用吻合器痔上黏膜环切术配合中药坐浴治疗。对比两组临床疗效、围术期指标、中医证候积分及并发症发生率。结果研究组总有效率为93.33%高于对照组的73.33%,差异有显著性(P<0.05);研究组疼痛持续时间为(2.30±0.69)天,肛门水肿消失时间为(12.03±2.14)d,创面渗液消失时间为(11.24±2.16)d,肛门坠胀缓解时间为(10.47±2.45)d,均短于对照组,分别为(5.48±1.16)d、(15.82±3.49)d、(14.25±3.57)d、(13.94±2.16)d,镇痛药物使用次数为(1.41±0.32)次,少于对照组的(6.58±1.40)次,差异有显著性(P<0.05);研究组术后肛管最大收缩压为(123.76±10.85)mmHg,肛管静息压为(33.74±4.53)mmHg,均低于对照组,分别为(141.29±11.73)mmHg、(50.12±4.79)mmHg,差异有显著性(P<0.05);研究组并发症发生率为6.67%,低于对照组的26.67%,差异有显著性(P<0.05)。结论吻合器痔上黏膜环切术配合中药坐浴治疗Ⅱ~Ⅳ度痔疮效果显著,能够缩短创面愈合时间,缓解术后疼痛,促进创面愈合,具有肛门功能保护效应,安全可靠。

Objective To explore the clinical effect of prolapse and hemorrhoids circumcision(PPH)combined with Chinese medicine sitz bath in the treatment ofⅡ~Ⅳdegree hemorrhoids.Methods Sixty patients with gradeⅡ~Ⅳhemorrhoids who underwent surgical treatment in our hospital from July 2017 to December 2019 were selected and divided into two groups with 30 cases by random number table.The control group underwent external stripping and internal ligation,and the study group was treated with PPH combined with Chinese medicine sitz bath.The clinical efficacy,perioperative indicators,TCM syndrome scores and complications were compared between the two groups.Results The total effective rate of the study group was 93.33%higher than that of the control group 73.33%,the difference was statistically significant(P<0.05);the duration of pain in the study group was(2.30±0.69)d,and the time of anal edema disappeared was(12.03±2.14)d.The disappearance time of wound exudate was(11.24±2.16)d,and the relief time of anal bulging was(10.47±2.45)d,which were shorter than those of the control group(5.48±1.16)d,(15.82±3.49)d,(14.25±3.57)d,(13.94±2.16)d,the number of times of analgesic use was(1.41±0.32)times,which was less than(6.58±1.40)times in the control group,the difference was statistically significant(P<0.05);The maximum systolic pressure of the posterior anal canal was(123.76±10.85)mmHg and the resting pressure of the anal canal was(33.74±4.53)mmHg,which were lower than those of the control group(141.29±11.73)mmHg and(50.12±4.79)mmHg,the difference was statistically significant Significance(P<0.05);the complication rate in the study group was 6.67%,which was lower than 26.67%in the control group,and the difference was statistically significant(P<0.05).Conclusion PPH combined with traditional Chinese medicine sitz bath has a significant effect on the treatment ofⅡ~Ⅳdegree hemorrhoids.It can shorten the wound healing time,relieve postoperative pain,and promote wound healing.It has anal protective effect and is safe and reliable.