肛周熏洗对肛周脓肿术后水肿、疼痛及炎症反应状态的影响

Influence of Perianal Fumigation and Washing for Postoperative Edema, Pain and Inflammatory Reaction State of Patients with Perianal Abscess

目的:探究肛周熏洗对肛周脓肿术后水肿、疼痛及炎症反应状态的影响。方法:选取2020年1月-2021年10月湖南中医药大学第三附属医院的80例肛周脓肿手术患者为研究对象,将其根据随机数字表法分为对照组和观察组,每组40例。对照组采用常规治疗,观察组在对照组的基础上采用肛周熏洗。比较两组的创面愈合时间,术后1、2周的肉芽组织生长评分,术后1、3、7 d的水肿程度评分及疼痛程度[视觉模拟评分(VAS评分)],术前及术后3、5 d的炎症反应指标[血清C反应蛋白(CRP)及肿瘤坏死因子-α(TNF-α)]。结果:观察组的创面愈合时间显著短于对照组,术后1、2周的肉芽组织生长评分、术后1、3、7 d的水肿程度评分及VAS评分均显著低于对照组,差异均有统计学意义(P<0.05)。术前,两组的血清CRP及TNF-α比较,差异均无统计学意义(P>0.05);术后3、5 d,观察组的血清CRP及TNF-α均显著低于对照组,差异均有统计学意义(P<0.05)。结论:肛周熏洗可显著改善肛周脓肿术后水肿、疼痛及炎症反应状态,在肛周脓肿手术患者中的应用价值较高。

Objective:To investigate the influence of perianal fumigation and washing for postoperative edema,pain and inflammatory reaction state of patients with perianal abscess.Method:A total of 80 surgical patients with perianal abscess in the Third Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 2020 to October 2021 were chosen as the study objects,and they were divided into control group and observation group by the random number table,with 40 cases in each group.The control group was treated with routine treatment,and the observation group was treated with perianal fumigation and washing on the basis of the control group.The wound healing time,granulation tissue growth score at 1 and 2 weeks after operation,edema degree score and pain degree[visual analogue scale (VAS score)]at 1,3,7 d after operation and inflammatory reaction indexes[serum C reactive protein (CRP) and tumor necrosis factor-α (TNF-α)]before and 3,5 d after operation were compared between the two groups.Result:The wound healing time of observation group was significantly shorter than that of control group,the granulation tissue growth score at 1 and 2 weeks after operation,edema score and VAS score at 1,3,7 d after operation were all significantly lower than those of control group,there were statistically significant differences (P<0.05).There were no statistically significant differences in serum CRP and TNF-α between the two groups before operation (P>0.05);the serum CRP and TNF-αof observation group at 3 and 5 d after operation were significantly lower than those of control group,there were statistically significant differences (P<0.05).Conclusion:The perianal fumigation and washing can significantly improve the postoperative edema,pain and inflammatory reaction state of patients with perianal abscess,so its application value in the surgical patients with perianal abscess is higher.