Analysis of factors impacting postoperative pain and quality of life in patients with mixed hemorrhoids:A retrospective study

BACKGROUND Hemorrhoids are among the most common and frequently encountered chronic anorectal diseases in anorectal surgery.They are venous clusters formed by con-gestion,expansion,and flexion of the venous plexus in the lower part of the rec-tum.Mixed hemorrhoids bleed easily and recurrently,and this can result in severe anemia.Hence,they may have a negative effect on the health of the patient and surgical treatment is required.Milligan-Morgan hemorrhoidectomy has been widely used since 1937 for the treatment of grade III and IV hemorrhoids.How-ever,most patients experience different degrees of postoperative pain that may cause anxiety.with mixed hemorrhoids post-surgery.METHODS The clinical data of patients with mixed hemorrhoids who underwent Milligan-Morgan hemorrhoidectomy were collected retrospectively.The basic character-istics of the enrolled patients with mixed hemorrhoids were recorded,and based on the Goligher clinical grading system,the hemorrhoids were classified as grades III or IV.The endpoint of this study was the disappearance of pain in all patients.Quantitative data were presented as mean±SD,such as age,pain score,and QoL score.Student’s t-test was used to compare the groups.RESULTS A total of 164 patients were enrolled.The distribution of the visual analog scale pain scores of all patients at 3,7,14 and 28 d after surgery showed that post-surgery pain was significantly reduced with the passage of time.Fourteen days after the operation,the pain had completely disappeared in some patients.Twenty-eight days after the surgery,none of the patients experienced any pain.Comparing the World Health Or-ganization Quality of Life-BREF self-reporting questionnaire scores of patients between 14 and 28 d after surgery,we observed that the quality-of-life scores of the patients post-surgery had significantly improved.There were six items that were compared at 14-and 28-d post-surgery.The mean QoL score 28 d after surgery(4.79±0.46)was higher than that at 14 d post-surgery(3.79±0.57).The mean health condition score 28 d after surgery(4.80±0.41)was also higher than that at 14 d post-surgery(4.01±0.62).The mean physical health score 28 d after surgery(32.10±2.96)was significantly higher than that at 14 d post-surgery(23.41±2.85).The mean psychological health score 28 d after surgery(27.22±1.62)was significantly higher than that at 14 d post-surgery(21.37±1.70).The mean social relations score 28 d after surgery(12.21±1.59)was significantly higher than that at 14 d post-surgery(6.32±1.66).The mean surrounding environment score 28 d after surgery(37.13±2.88)was significantly higher than that at 14 d post-surgery(28.42±2.86).The differences in quality-of-life scores at day 14 and day 28 post-surgery were ob-served to be statistically significant(P<0.001).CONCLUSION Milligan-Morgan hemorrhoidectomy can significantly improve the postoperative QoL of patients.Age,sex,and the number of surgical resections were important factors influencing Milligan-Morgan hemorrhoidectomy.

Clinical Observation of Chinese Medicinal Prescriptions for Swelling and Pain in The Postoperative Treatment of Mixed Hemorrhoids

Objective:To observe the clinical effect of traditional Chinese medicine(TCM)on reducing swelling and pain in patients with mixed hemorrhoids.Methods:Sixty patients with mixed hemorrhoids who were admitted to the Hospital of Traditional Chinese Medicine of Qiqihar from January 2023 to January 2024 were selected and divided into two groups.The treatment group(n=30)was treated with mixed hemorrhoid ligation combined with traditional Chinese swelling and pain medicine,and the control group(n=30)was only treated with mixed hemorrhoid ligation.The pain level,edema score,and prognosis of the two groups after the intervention were analyzed.The clinical efficacy was used as the evaluation criterion to compare the clinical effects of different treatment options.Results:After the treatment,the pain score,edema score,and prognostic wound score of the treatment group were all lower than those of the control group(P 0.05).The total clinical effectiveness of the treatment group(100%)was higher than that of the control group(76.67%),(χ^(2)=4.2857,P<0.05).Conclusion:The application of traditional Chinese swelling and pain medicine in treating patients with mixed hemorrhoids effectively reduced the patient’s pain,reduced the degree of wound edema,promoted wound healing,and improved the patient’s prognosis.The curative effect was significant and had a positive impact.

Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection for circumferential mixed hemorrhoids

AIM:To identify a more effective treatment protocol for circumferential mixed hemorrhoids.METHODS:A total of 192 patients with circumferential mixed hemorrhoids were randomized into the treatment group,where they underwent Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection,or the control group,where traditional external dissection and internal ligation were performed.Postoperative recovery and complications were monitored.RESULTS:The time to wound healing was 12.96 ± 2.25 d in the treatment group shorter than 19.58 ± 2.71 d in the control group.Slight pain rate was 58.3% in the treatment group higher than 22.9% in the control group;moderate pain rate was 33.3% in the treatment group lower than 56.3% in the control group severe pain rate was 8.4% in the treatment group lower than 20.8% in the control group.No edema rate was 70.8% in the treatment group higher than 43.8% in the control group;mild local edema rate was 26% in the treatment group lower than 39.6% in the control group obvious local edema was 3.03% in the treatment group lower than 16.7% in the control group.No stenosis rate was 85.4% in the treatment group higher than 63.5% in the control group;moderate stenosis rate was 14.6% in the treatment group Lower than 27.1% in the control group severe anal stenosis rate was 0% in the treatment group lower than 9.4% in the control group.CONCLUSION:Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection is the optimal treatment for circumferential mixed hemorrhoids and can be widely applied in clinical settings.

Clinical Observation on 80 Cases of Anal Edema after Mixed Hemorrhoids Operation with Chinese Medicine Hot Election Package

The subjects of this study were 80 patients who underwent mixed hemorrhoids surgery in our hospital from January to October 2020 (mixed hemorrhoids external and internal ligation, internal hemorrhoids ligation or Xiaozhiling injection) and developed anal edge edema after surgery. According to the order of hospitalization, the patients were randomly divided into treatment group and control group, with 40 cases each. In the control group, blank hot pack was applied on the basis of anorectal No. 1 lotion for prevention and treatment of anal edge edema after operation;in the treatment group, hot pack of Traditional Chinese medicine was applied on the basis of anorectal No. 1 lotion for prevention and treatment of anal edge edema. The course of treatment was 7 days. The edema subsidence and postoperative pain scores were observed in both groups. Results: The scores of anal edema and pain in the treatment group were significantly lower than those in the control group (P < 0.05), and the significant efficiency and total effective rate in the treatment group were significantly better than those in the control group, with statistical difference (P < 0.05). Conclusion: Chinese medicine hot election package is effective in treating postoperative anal edema of mixed hemorrhoids, and the method is simple and suitable for clinical promotion.

Research progress of traditional Chinese medicine nursing techniques for the management of postoperative complications in mixed hemorrhoids

Mixed hemorrhoids,especially ring-shaped mixed hemorrhoid,is still a headache for anorectal surgeons due to its post-operative complications.In recent years,clinicians have been studying and exploring to avoid and alleviate these complications.In the Chinese medicine industry,the application of traditional Chinese medicine nursing technology has good and unique effect in prevent local pain,perianal edema,promote wound healing,relieve urinary retention,improve constipation,relieve anxiety,and so on.This article summarized the evidences of investigated the role of traditional Chinese medicine nursing technique in preventing and treating mixed hemorrhoid so that practitioners can make decision based on the best available evidences.

Effect of auricular acupoint sticking and pressing on postoperative pain of patients with mixed hemorrhoids:A Meta-analysis

Objective:To systematically evaluate the application effect of auricular acupuncture in postoperative analgesia in patients with mixed hemorrhoids.Methods:We searched Chinese Biomedical Literature Database,CNKI,WanFang,PubMed,Embase,and The Cochrane Library to collect randomized controlled trials about auricular acupuncture on Postoperative patients with mixed hemorrhoids.According to the inclusion criteria and exclusion criteria screening literature.RevMan 5.3 software was used for meta-analysis.Results:A total of 20 articles and 21 studies were included,including 1999 patients after mixed hemorrhoids.The control group was treated with routine nursing analgesia.The experimental group was treated with auricular acupressure beans based on the control group.The meta-analysis showed that the pain relief rate of the experimental group was better than that of the control group[OR=2.84,95%CI(2.12,3.80),P<0.05].Subgroup analysis showed that the application of auricular acupressure after milligan morgan was superior to the control group in the analgesic effect[OR=3.68,95%CI(2.62,5.18),P<0.05],but it is not yet possible to apply auricular acupoint pressing to relieve pain after Stapler hemorrhoidectomy(P>0.05).The pain scores of 24 hours and 48 hours after operation in the experimental group were lower than those of the control group,indicating that auricular acupoint sticking can relieve the pain after operation.The improvement of the postoperative anal margin edema was better in the experimental group than in the control group,24 h[SMD=-1.99,95%CI(-2.84,-1.14),P<0.05],48 h[SMD=-1.92,95%CI(-2.72,-1.11),P<0.05].The adverse reactions were lower than the control group.Conclusion:The application of ear acupoint pressure pea after external exfoliation of mixed hemorrhoids can improve the analgesic effect and reduce the symptoms of postoperative anal edge edema,and the price is low,the operation is convenient,and the side effects are few.It is recommended to be popularized in clinical practice.

Progress in the Treatment of Edema After Surgery for Mixed Hemorrhoids

Edema is a common postoperative complication in mixed hemorrhoids.With the development of medical treatment,surgical improvement has greatly reduced surgical trauma to the body,but the issue of postoperative edema still exists.In order to explore the treatment progress of edema after surgery for mixed hemorrhoids,literatures on integrated traditional Chinese and western medicine for postoperative edema in hemorrhoids have been reviewed in hope to better understand the complication and provide reference for relevant clinical studies in the future.

Aluminum potassium sulfate and tannic acid sclerotherapy for Goligher Grades Ⅱ and Ⅲ hemorrhoids: Results from a multicenter study

AIM: To show that aluminum potassium sulfate and tannic acid(ALTA) sclerotherapy has a high success rate for Grade Ⅱ and Ⅲ hemorrhoids.METHODS: This study was based on the clinical data of 604 patients with hemorrhoids who underwent ALTA sclerotherapy between January 2009 and February 2015. The objective of this study was to assess the efficacy of this treatment for Grades Ⅱ and Ⅲ hemorrhoids. Preoperative and postoperative symptoms, complications and success rate were all assessed retrospectively. Follow-up consisted of a simple questionnaire, physical examination and an anoscopy. Patients were followed-up at one day, one week, two weeks, one month, one year, two years, three years, four years and five years after the ALTA sclerotherapy.RESULTS: One hundred and sixty-nine patients were diagnosed with Grade Ⅱ hemorrhoids and 435 patients were diagnosed with Grade Ⅲ hemorrhoids. The one year, three year and five year cumulative success rates of ALTA sclerotherapy for Grades Ⅱ and Ⅲ hemo-rrhoids were 95.9% and 93.1%; 89.3% and 83.7%; and 89.3% and 78.2%, respectively. No significant differences were observed in the cumulative success rates after ALTA sclerotherapy between Grades Ⅱ and Ⅲ hemorrhoids(P = 0.09). There were forty-seven post-operative complications(low grade fever; anal pain; urinary retention; rectal ulcer; and others). No serious or life-threatening complications occurred and all cases improved through conservative treatment. At univariate analysis there were no predictive factors of failure.CONCLUSION: ALTA sclerotherapy has had a high success rate for Grade Ⅱ and Ⅲ hemorrhoids during five years of post-operative treatment. However, additional studies are needed to evaluate the efficacy of this ALTA sclerotherapy in the management of hemorrhoidal disease.

Effect of moxibustion combined with five‑element music therapy on postoperative pain relief after mixed hemorrhoid operation

Objective:To investigate the effect of moxibustion combined with five‑element music therapy on the postoperative pain relief of patients undergoing surgical operation for mixed hemorrhoid with damp‑heat syndrome.Methods:Totally,159 patients meeting the inclusion criteria were assigned to the control group,study group 1,and study group 2,with 53 cases in each group.All patients received routine care after surgical treatment,including acupoint application and Chinese herbal fumigation.In addition,patients in the study group 1 received moxibustion,and those in the study group 2 were given moxibustion combined with five‑element music therapy.The degree of postoperative pain was evaluated using visual analog scale(VAS).Results:There was no significant difference in VAS score on pain during dressing changes among three groups(P>0.05).After 3,5,and 7 days of intervention,there was a significant difference in VAS score on pain at rest among three groups(P<0.001),and VAS score in the study group 2 was lower than that in the study group 1 and the control group after 3 and 5 days of intervention,respectively(P<0.05).Conclusion:Moxibustion combined with five‑element music therapy is effective to relieve the postoperative pain of patients undergoing a surgical operation for mixed hemorrhoids with damp‑heat syndrome.

选择性痔上黏膜切除吻合术治疗Ⅲ度混合痔的5-HT、PGE2及IL-6水平变化及疗效

目的 分析选择性痔上黏膜切除吻合术(TST)治疗Ⅲ度混合痔的神经递质及5-羟色胺(5-HT)、前列腺素E2(PGE2)及白介素-6(IL-6)水平变化及临床疗效。方法 本研究采用单中心回顾性研究方法,收集2020年5月至2023年1月大连市中心医院收治的108例Ⅲ度混合痔患者,依据治疗方式分为对照组[n=53,予吻合器痔上黏膜环切术(PPH)治疗]和观察组(n=55,予TST治疗)。对比两组临床疗效、围手术期指标(手术时长、术中出血量、住院时间、术后首次排便时间、术后卧床时间)、5-HT、PGE2、炎性因子[IL-6、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平]、肛肠动力学指标[直肠感知阈值(RSTV)、肛管静息压(RASP)、直肠最大容量阈值(RMTV)]及并发症发生率。结果 观察组临床总有效率(94.55%)比对照组(81.13%)高,差异有统计学意义(P<0.05);观察组术后首次排便时间、手术时长、术后卧床时间及住院时间比对照组短,术中出血量比对照组少,差异有统计学意义(P<0.05);治疗后,两组5-HT、PGE2水平均下降,且观察组比对照组低,差异有统计学意义(P<0.05);治疗后,两组IL-6、CRP、TNF-α水平均下降,且观察组比对照组低,差异有统计学意义(P<0.05);治疗后,观察组RSTV、RMTV比对照组高,RASP比对照组低,差异有统计学意义(P<0.05);观察组并发症总发生率(7.28%)比对照组(20.75%)低,差异有统计学意义(P<0.05)。结论 采用TST治疗Ⅲ度混合痔患者疗效更显著,明显改善了患者围术期指标,降低了患者5-HT、PGE2及IL-6、TNF-α、CRP炎性因子水平,降低术后并发症发生率,利于术后恢复。

Clinical Experience Sharing Of 218 Cases without Hemorrhage after Procedure for Prolapse and Hemorrhoids

Objective:To summarize the experience without hemorrhage after PPH of 218 patients with mixed hemorrhoid.Methods:PPH(Procedure for prolapse and hemorrhoids)was performed routinely.During operation,it is paid attention that the hemorrhoid artery should be completely mutilated,the anastomat should be squeezed before and after the anastomosis,the anastomosis should be carefully examined,the hemostasis should be completely performed,and relevant hemostasis measures should be taken after the operation.Results:None of the 218 patients had postoperative hemorrhage.Conclusion:Relevant measures can be taken after operation to prevent the occurrence of postoperative hemorrhage.

促愈熏洗方联合艾灸治疗Ⅲ期痔病术后临床疗效观察

目的探讨促愈熏洗方联合艾灸对Ⅲ期痔病术后疼痛、出血、水肿、住院天数及创面愈合时间的影响。方法选取接受手术治疗的213例Ⅲ期痔病术后患者,分为促愈熏洗方+艾灸组、促愈熏洗方组、痔疾洗液组,各71例。促愈熏洗方+艾灸组予促愈熏洗方坐浴联合自动灸疗仪治疗,促愈熏洗方组予促愈熏洗方坐浴治疗,痔疾洗液组予痔疾洗液坐浴治疗。观察各组患者疼痛、出血、水肿症状改善情况、住院天数及创面愈合时间差异。结果术后1、3、7、21天,促愈熏洗方+艾灸组疼痛评分明显优于促愈熏洗方组与痔疾洗液组(P<0.05);促愈熏洗方+艾灸组在3、7、21天出血积分明显低于痔疾洗液组(P<0.05);术后第7、21天促愈熏洗方+艾灸组与促愈熏洗方组水肿评分低于痔疾洗液组(P<0.05);促愈熏洗方+艾灸组与促愈熏洗方组在改善手术1周后水肿方面具有明显优势;促愈熏洗方+艾灸组与促愈熏洗方组创面愈合时间均少于痔疾洗液组(P<0.05);促愈熏洗方+艾灸组较痔疾洗液组住院天数明显减少(P<0.05)。结论促愈熏洗方联合艾灸可有效缓解Ⅲ期痔病术后疼痛、出血、水肿症状,缩短创面愈合时间,提高临床疗效与生活质量。

马应龙麝香痔疮膏对老年Ⅱ~Ⅲ期压疮患者炎症反应及创面愈合情况的影响

目的探讨马应龙麝香痔疮膏对老年Ⅱ~Ⅲ期压疮患者炎症反应及创面愈合情况的影响。方法按随机数字表法分配原则将2020年1月—2022年6月医院收治的68例老年Ⅱ~Ⅲ期压疮患者分为对照组(34例)和治疗组(34例)。两组均进行常规消毒清创,对照组在常规消毒清创基础上给予利凡诺创伤膏纱条外敷,治疗组在常规消毒清创基础上给予马应龙麝香痔疮膏纱条外敷,两组均连续治疗2周。比较两组治疗2周后的疗效,临床症状改善情况,治疗前、治疗2周后的创面愈合情况、疼痛程度、炎症指标及血管内皮功能指标。结果与对照组比较,治疗组治疗2周后的总有效率较高[85.29%(29/34)vs 55.88%(19/34),P<0.05]。与对照组比较,治疗组渗液消失时间、新生肉芽组织生长时间及压疮愈合时间均较短(P<0.05)。与治疗前比较,治疗2周后,两组创面面积、创面组织类型、渗液量、视觉模拟评分法(visual analogue scale,VAS)评分及血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-1β(interleukin-1β,IL-1β)、C反应蛋白(C-reactive protein,CRP)水平均降低,治疗组低于对照组(P<0.05);两组血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)、表皮细胞生长因子(epidermal growth factor,EGF)水平均升高,治疗组高于对照组(P<0.05)。结论马应龙麝香痔疮膏可明显减轻老年Ⅱ~Ⅲ期压疮患者炎症反应,改善血管内皮功能,缓解创面疼痛,进而有助于改善患者临床症状,促进创面愈合,疗效显著。

自动痔疮套扎术联合消痔灵、藻酸盐粉治疗Ⅲ度混合痔的临床疗效

目的探讨自动痔疮套扎术联合消痔灵、藻酸盐粉治疗Ⅲ度混合痔的临床疗效。方法选取2022年6月-2023年5月空军特色医学中心收治的84例Ⅲ度混合痔患者,按照不同治疗方法分为对照组与研究组,每组42例。对照组行自动痔疮套扎术联合消痔灵治疗,研究组在对照组的基础上加用藻酸盐粉。观察两组的临床疗效、恢复情况、并发症及术后3、7、12 d的创面愈合率,统计并比较两组治疗前与治疗3周后的肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、转化生长因子-β1(TGF-β1)水平。结果研究组总有效率高于对照组(P<0.05)。研究组治疗前后TNF-α、IL-8、TGF-β1水平差值均高于对照组(P<0.05)。研究组肛门水肿、出血及渗液的消失时间、创面愈合时间均短于对照组(P<0.05)。研究组与对照组术后3、7、12 d的创面愈合率比较,结果:①不同时间点创面愈合率比较,差异有统计学意义(P<0.05);②研究组与对照组的创面愈合率比较,差异有统计学意义(P<0.05),与对照组相比,研究组的创面愈合率较高,相对愈合效果较好;③研究组与对照组的创面愈合率变化趋势比较,差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论自动痔疮套扎术联合消痔灵、藻酸盐粉治疗,可促进术后的恢复和创面的愈合,更好地减轻炎症反应,提高疗效,且安全性良好。

弹力线套扎治疗Ⅲ°~Ⅳ°非环状混合痔的临床疗效

目的探讨弹力线套扎(elastic thread ligation,ETL)治疗Ⅲ°~Ⅳ°非环状混合痔的临床疗效。方法选取2020年7月至2022年1月遵义医科大学第三附属医院肛肠科收治的100例Ⅲ°~Ⅳ°非环状混合痔患者作为研究对象,随机分为ETL组与橡皮筋结扎(rubber band ligation,RBL)组,每组50例。ETL组行ETL治疗,RBL组行RBL治疗。比较两组手术时间、住院时间、恢复工作时间、套扎创面愈合时间、术后第1天视觉模拟评分法(visual analogue scale,VAS)评分、临床疗效及术后肛门坠胀、术后出血、复发情况。结果ETL组住院时间、恢复工作时间、套扎创面愈合时间均短于RBL组,差异有统计学意义(P<0.05)。ETL组术后无出血发生率为94.00%,高于RBL组的78.00%,差异有统计学意义(P<0.05)。两组手术时间、术后肛门坠胀发生率、术后第1天VAS评分、术后6个月复发率比较差异均无统计学意义。两组治疗总有效率均为100.00%,两组比较差异无统计学意义。结论ETL治疗Ⅲ°~Ⅳ°非环状混合痔疗效显著,可降低患者术后出血发生率,缩短套扎基底部创面愈合时间、住院时间及恢复工作时间,值得临床推广应用。

上提固定结合整形微创治疗Ⅲ、Ⅳ度混合痔的临床研究

目的:研究上提固定结合整形微创治疗Ⅲ、Ⅳ度混合痔的临床疗效。方法:选取2021年1月—2022年3月收治的80例混合痔患者,按就诊单双日次序分为治疗组和对照组,每组各40例。治疗组采用上提固定结合整形微创治疗混合痔,对照组采用混合痔外切内扎术。比较两组临床疗效、术后第1、3、7天疼痛评分、肛周水肿评分以及便血评分,首次排便时间、排便疼痛消失时间、便血消失时间、住院时间、恢复工作时间,术后肛门功能评价及复发情况。结果:两组的总有效率差异无统计学意义(P>0.05)。治疗组术后1、3、7 d的VAS疼痛评分、肛周水肿评分及便血评分均低于对照组,差异有统计学意义(P<0.05)。治疗组患者的首次排便时间、排便疼痛消失时间、便血消失时间、住院时间、恢复工作时间均低于对照组,差异有统计学意义(P<0.05)。治疗组患者在术后1周、术后1个月的肛门失禁Wexner评分均明显低于对照组(P<0.05),而在术后4、8个月时,两组患者评分无明显差异(P>0.05)。在术后8个月电话随访中,两组患者未诉复发情况。结论:上提固定结合整形微创治疗Ⅲ、Ⅳ度混合痔疗效确切,在减轻术后肛门疼痛、肛周水肿、便血等症状及降低手术对肛门功能影响方面优势明显。

自动痔疮套扎术治疗Ⅲ Ⅳ期混合痔的近期效果及安全性分析

目的:研究自痔痤疮套扎术治疗Ⅲ、Ⅳ期混合痔的近远期疗效及安全性。方法:选取2014年6月到2016年8月Ⅲ、Ⅳ期混合痔患者116例,采用分层随机分组法将其分为对照组和观察组,每组各58例。对照组患者接受外剥内扎术(M-M)治疗,观察组患者接受自动痔疮套扎术(RPH)治疗,比较两组患者的手术时间、创面愈合时间、住院时间、术后VAS评分、手术治疗总有效率及并发症发生率。结果:观察组的手术总有效率(93.10%)明显高于对照组(77.59%,P<0.001);观察组的手术时间、创面愈合时间、住院时间及术后VAS评分均明显低于对照组(P<0.01);观察组的总并发症发生率(6.89%)明显低于对照组(32.75%,P<0.001)结论:RPH治疗Ⅲ、Ⅳ期混合痔的临床疗效显著,可促进创面的愈合,降低术后疼痛感,且治疗安全性高。

痔上黏膜套扎术结合痔核剥切技术在治疗高龄患者Ⅲ～Ⅳ度混合痔中的临床价值

目的评价痔上黏膜套扎术结合痔核剥切技术在治疗高龄中重度混合痔患者的临床价值。方法选择2011年5月-2013年12月北京中医药大学附属护国寺中医医院外科收治的166例高龄Ⅲ-Ⅳ度混合痔患者,根据随机数字表法分为A组（57例）、B组（54例）和C组（55例）。A组采用痔上黏膜套扎术配合痔核剥切技术,B组行传统混合痔外切内扎技术,C组行吻合器痔上黏膜环切吻合术结合痔核剥切技术。记录并比较三组患者在的手术操作时间、临床疗效、术后并发症、住院时间、住院费用和术后12个月复发率的结果。结果三组患者在术后疼痛和出血积分比较,差异有统计学意义（P〈0.05）,且A组优于B组和C组,差异有统计学意义（P〈0.05）。三组患者的术后并发症发生率比较,差异有统计学意义（P〈0.05）,且A组（7.0%）低于B组（27.6%）和C组（15.8%）,差异有统计学意义（P〈0.05）。三组患者的手术住院时间比较,差异有统计学意义（P〈0.05）,且A组[（7.42±2.01）d]少于B组[（12.45±2.18）d]和C组[（10.28±2.36）d],差异有统计学意义（P〈0.05）。三组患者住院费用比较,差异有统计学意义（P〈0.05）,且A组[（3560.06±201.37）元]少于C组[（5634.17±276.68）元],差异有统计学意义（P〈0.05）。三组患者的术后12个月复发率比较,差异有统计学意义（P〈0.05）,且A组（3.5%）少于B组（14.8%）和C组（10.9%）,差异有统计学意义（P〈0.05）。结论痔上黏膜套扎术结合痔核剥切技术对于高龄中、重度痔疮患者的治疗,具有损伤小、术后并发症少、住院时间短、治疗费用少、复发率低等优点,是一种微创、安全、有效、经济的方法。

Effects of electroacupuncture at Chéngshān (承山 BL 57) on postoperative pain of mixed hemorrhoids

ABSTRACT Objective To discuss the effect of electroacupuncture at Chengshan （承山 BL 57） on postoperative pain of mixed hemorrhoids. Methods One hundred and twenty cases with postoperative pain of mixed hemorrhoids were divided into an electroacupuncture group （60 cases） and a medication group （60 cases） randomly. In electroacupuncture group disperse-dense wave in frequency of 2 Hz/100 Hz was adopted at Chengshan （承山 BL 57）, the first treatment was given within 30 min after the operation, from the second day on electroacupuncture treatment was applied once a day and each time after hip bath in the morning. While in medication group 2 tablets of Naproxen Sunstained Release Capsule were administered orally within 30 min after operation, later on 2 tablets were taken before dressing change in the day. After 4 times of treatment, evaluate the changed condition of Visual Analogue Scale （VAS） at 5 h, 24 h, 48 h and 72 b after operation. Results In electroacupuncture group all tested pain scores at 5 h, 24 h, 48 h and 72 h after operation （6.78±2.12, 5.56±1.87, 4.34±2.23 and 3.15±2.11） were lower than those in the medication group （7.56±2.01, 6.23±1.15, 5.57±2.21 and 4.34±2.12）, and the difference was statistically significant （all P〈0.05）. Conclusion Electroacupuncture at Chengshan （承山 BL 57） can reduce the postoperative oain of mixed hemorrhoids.

支架式与固定式前牵引矫治替牙期骨性Ⅲ类错牙合的比较

目的:对比铸造支架式与传统固定式上颌前牵引矫治替牙期骨性Ⅲ类错的疗效。方法:30例替牙期骨性Ⅲ类错患者随机分为2组,第1组应用铸造支架式前牵引(15例),第2组应用传统固定式前牵引(15例)进行矫治。用SPSS13.0对2组病例矫治前后头影测量结果、治疗时间以及复诊次数进行统计学分析。结果:治疗持续时间第1组为(7.03±1.32)个月,第2组为(9.07±1.31)个月(P<0.05);复诊次数第1组(8.00±1.46)次,第2组(10.47±1.85)次(P<0.05);头影测量第1组的△U1-SN为(3.85±0.95)°,第2组的△U1-SN(5.25±0.95)°(P<0.05),其余各指标的改变量无统计学差异。结论:铸造支架式前牵引为一种高效、实用的前牵引口内装置,可以在一定程度上防止上前牙唇倾。