改良外剥内扎术配合中药熏洗治疗环状混合痔临床研究

Clinical Study of Modified External Hemorrhoidectomy Combined with Traditional Chinese Medicine Fumigation Therapy for Mixed Hemorrhoids

目的探索改良外剥内扎术配合术后中药熏洗治疗环状混合痔的临床效果。方法纳入2021年1月至2023年12月在漳州市龙海区紫泥卫生院就诊的120例环状混合痔疮患者,按治疗手段的不同,分为研究组与对照组,研究组采取改良外剥内扎术配合术后中药熏洗,对照组采取传统内扎外剥术,每组各60例。比较两组患者手术相关指标及住院时间,术后临床症状评分,临床疗效及并发症。结果研究组术中出血量及住院时间均显著少于对照组(P<0.001),但研究组手术时间长于对照组(P<0.001)。术后,研究组创面疼痛、便时出血、肛门坠胀、肛缘水肿评分均低于对照组(P<0.001)。术后1个月,研究组临床有效率为95.00%,显著高于对照组的81.67%(P<0.05),差异有统计学意义。术后1年,研究组并发症发生率为1.67%,与对照组的5.00%相比,差异无统计学意义(P>0.05)。结论改良外剥内扎术配合术后中药熏洗可减少环状混合痔术中出血量,改善术后创面疼痛、便时出血、肛门坠胀及肛缘水肿程度,提高了临床疗效。

Objective To explore the clinical efficacy of modified external stripping and internal ligation surgery combined with postoperative traditional Chinese medicine fumigation for the treatment of circular mixed hemorrhoids.Methods 120 patients with circular mixed hemorrhoids treated at Zini Health Center in Longhai District,Zhangzhou,from January 2021 to December 2023 were included in this study.The patients were divided into the study group and the control group,with 60 cases in each group.The study group received modified external stripping and internal ligation surgery combined with postoperative traditional Chinese medicine fumigation,while the control group received traditional internal ligation and external stripping surgery.Surgical-related indicators,hospitalization duration,postoperative clinical symptom scores,clinical efficacy,and complications were compared between the two groups.Results The study group had significantly less intraoperative blood loss and shorter hospitalization duration compared to the control group(P<0.001).The operation time was longer in the study group than that in the control group(P<0.001).Postoperatively,the study group had lower scores for wound pain,bleeding during defecation,anal heaviness,and perianal edema compared to the control group(P<0.001).One month post-surgery,the clinical efficacy rate in the study group was 95.00%,which was significantly higher than the clinical efficacy rate(81.67%)in the control group(P<0.05).One year post-surgery,the complication rate in the study group was 1.67%,which was not significantly different from the complication rate(5.00%)in the control group(P<0.05).Conclusion Modified external stripping and internal ligation surgery combined with postoperative traditional Chinese medicine fumigation can reduce intraoperative blood loss,improve postoperative wound pain,bleeding during defecation,anal heaviness,and perianal edema,thereby enhancing the clinical efficacy in the treatment of circular mixed hemorrhoids.