PPH术联合消痔灵注射在非动力型出口梗阻型便秘治疗中的临床效果观察

Clinical observation of PPH procedure combined with Xiaozhiling injection in the treatment of nondynamic outlet obstruction constipation

目的探讨吻合器痔上黏膜环切术(PPH术)配合消痔灵注射对非动力型出口梗阻型便秘(OOC)患者治疗中的临床疗效。方法208例非动力型出口梗阻型便秘患者,按照治疗方式不同分为对照组和观察组,每组104例。对照组行PPH术进行治疗,观察组在对照组的基础上加用消痔灵注射。比较两组患者的临床疗效、围术期指标、便秘症状严重程度(Wexner评分)、生活质量和并发症发生率。结果观察组临床总有效率为92.31%,显著高于对照组的81.73%,差异具有统计学意义(P<0.05)。两组手术时间、术中出血量、术后24 h疼痛评分、术后首次排便时间比较差异无统计学意义(P>0.05)。术后1、3、6个月,观察组Wexner评分分别为(5.25±1.53)、(6.52±2.86)、(7.41±1.60)分,显著低于对照组的(6.17±2.98)、(8.12±3.87)、(9.12±3.45)分,差异具有统计学意义(P<0.05)。观察组便秘患者生活质量量表(PAC-QOL)中身体不适、心理不适、担心与焦虑、满意度评分及总分分别为(5.12±3.45)、(7.54±6.14)、(15.26±8.19)、(9.70±4.41)、(37.62±10.44)分,均显著低于对照组的(7.26±3.19)、(9.48±5.18)、(19.15±9.41)、(12.18±4.51)、(48.07±10.22)分,差异具有统计学意义(P<0.05)。观察组并发症发生率为7.69%,显著低于对照组的21.15%,差异具有统计学意义(P<0.05)。结论采用PPH术配合消痔灵注射治疗非动力型出口梗阻型便秘临床效果显著,能够有效改善便秘,提升生活质量,降低并发症发生率,值得临床推广应用。

Objective To discuss the clinical efficacy of procedure for prolapse and hemorrhoids(PPH)procedure combined with Xiaozhiling injection in the treatment of non-dynamic outlet obstruction constipation(OOC).Methods A total of 208 patients with non-dynamic outlet obstruction constipation were divided into a control group and an observation group according to different treatment methods,with 104 cases in each group.The control group was treated with PPH procedure,and the observation group was treated with Xiaozhiling injection on the basis of the control group.The clinical efficacy,perioperative indexes,constipation symptom severity(Wexner score),quality of life and complication rate were compared between the two groups.Results The total clinical effective rate of 92.31%in the observation group was significantly higher than that of 81.73%in the control group,and the difference was statistically significant(P<0.05).There were no statistically significant differences in operative time,intraoperative blood loss,pain score at 24 h postoperatively and time to first postoperative defecation between the two groups(P>0.05).At 1,3 and 6 months postoperatively,Wexner scores in the observation group were(5.25±1.53),(6.52±2.86)and(7.41±1.60)points,which were significantly lower than those of(6.17±2.98),(8.12±3.87)and(9.12±3.45)points in the control group,and the differences were statistically significant(P<0.05).The scores of physical discomfort,psychological discomfort,worry and anxiety,satisfaction and total score in Patient Assessment of Constipation Quality of Life(PAC-QOL)of constipation patients in the observation group were(5.12±3.45),(7.54±6.14),(15.26±8.19),(9.70±4.41)and(37.62±10.44)points,which were significantly lower than those of(7.26±3.19),(9.48±5.18),(19.15±9.41),(12.18±4.51)and(48.07±10.22)points in the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 7.69%,which was significantly lower than that of 21.15%in the control group,and the difference was statistically significant(P<0.05).Conclusion The clinical effect of PPH procedure combined with Xiaozhiling injection in the treatment of non-dynamic outlet obstruction constipation is significant,which can effectively improve constipation,improve quality of life and reduce the incidence of complications.It is worthy of clinical promotion.