自动痔疮套扎术、外剥内扎术和注射治疗痔疮合并精神疾病的疗效与预后比较  

Curative Effect and Prognosis of Ruiyun Procedure for Hemorrhoids,Milligan Morgan Hemorrhoidectomy and Injiection Treating Patients with Hemorrhoids complicated with Mental Illness

作　　者：邱鹏[1] 高镇松[1] 柳勤斌[1] 肖逸丽[1] 陈仪[1] 

机构地区：[1]广东省汕头市第四人民医院,广东汕头515021

出　　处：《吉林医学》2016年第1期83-86,共4页Jilin Medical Journal

基　　金：2013年汕头市医疗科技计划项目[项目编号:汕府科(2013)88号第2项]

摘　　要：目的：探讨自动痔疮套扎术（RPH）、外剥内扎术（MMH）和注射治疗痔疮合并精神疾病的术后疗效和预后情况。方法：采用自动痔疮套扎器对2012年1月~2013年12月期间精神疾病并发痔疮患者63例（观察组）行RPH手术治疗,另选取30例同期行外剥内扎术（传统组）和30例行注射（注射组）治疗的痔疮合并精神疾病患者作为对照。三组治疗期间均进行一定的心理干预。比较三组疗效、手术时间、术后便血得到控制时间、住院时间、精神病量表（BPRS）和不良反应量表（TESS）得分、患者满意度、并发症发生率及随访1年内的复发率和简明精神病量表（BPRS）及不良反应量表（TESS）评价结果。结果：观察组治疗效果为痊愈和显著的患者比例及总治疗有效率分别为17.46%、46.03%和98.41%,均高于传统组的6.67%、20.00%和90.00%和注射组的10%、30%和93.33%,注射组治疗效果亦优于传统组,差异有统计学意义（P〈0.05）。观察组平均手术时间、术后便血得到控制时间和住院时间均较传统组明显缩短,观察组平均手术时间、术后便血得到控制时间亦短于注射组,住院时间则长于注射组;且传统组平均手术时间、术后便血得到控制时间和住院时间均长于注射组（P〈0.05）。三组BPRS和TESS得分比较差异均无统计学意义（P〉0.05）。观察组和传统组术后1年内的复发率均低于注射组（P〈0.05）。与注射组和传统组比较,观察组非常满意的患者比例及总体满意度均提高,术后出血、疼痛、肛周水肿、大便郁结、尿潴留、肛门坠胀等并发症的总发生率则降低;注射组非常满意的患者比例亦较传统组升高,并发症发生率则较传统组降低（P〈0.05）。结论：RPH、MMH和注射治疗痔疮合并精神疾病均可取得一定的疗效,其中以RPH的效果和安全性较优,值得临床推广使用。Objective To explore the curative effect and prognosis of Ruiyun procedure for hemorrhoids （RPH） , Milligan Morgan hemorrhoidectomy（MMH） and injiection（IJ） therapy in treating patients with hemorrhoids complicated with mental illness. Method 63 patients with mental illness and hemorrhoids and underwent RPH treatment from January,2012 to December,2013 were selected as observation group, and 30 patients mental illness and hemorrhoids and treated with MMH （MMH group） and 30 patients mental illness and hemorrhoids and treated with in the same period in our hospital were IJ （IJ group）were selected as control; All the patients in 3 groups had psychological intervention in treating. Curative effect, operation time, postoperative bloody got control time, hospitalization time, Brief Psychiatric Rating Scale （BPRS）and （TESS）score, patient satisfaction, complications and recurrence rate of 3 groups were compared. Results Recovery rate,significant curative effect rate and total treatment effective rate of observation group were 17.46% ,46. 03% and 98. 41% respectively,which were higher than the 6. 67% ,20. 00% and 90. 00% of MMH group and the 10% ,30% and 93.33% of IJ group ; Curative effect of IJ group was also better than that of the MMH group, and the difference was statistically significant （ P 〈 0. 05 ） ~ Compared with the MMH group, average operation time ,postoperative hematochezia control time and hospital stay of observation group were significantly shorter; Compared with IJ group, average operation time, postoperative hematochezia control time of observation group were shorter while hospital stay was longer; Compared with MMH group, average operation time, postoperative hematochezia control time and hos- pital stay of IJ group were shortened （ P 〈 0.05 ）. BPRS and TESS score of 3 groups had no statistical significant difference （ P 〉 0.05 ） ; Recurrence rate of observation group and MMH after one year were lower than that of the IJ group （ P 〉 0. 05 ）. Compared wi

关 键 词：自动痔疮套扎术 痔疮 精神疾病 外剥内扎术 注射 预后 

分 类 号：R657.18[医药卫生—外科学] R749[医药卫生—临床医学]