手术加中药湿敷治疗急性嵌顿性混合痔的疗效分析  

Analysis on Curative Effect of Wet Dressing of Chinese Drug Plus Surgery on the Treatment of Acute Incarcerated Mixed Hemorrhoids

作　　者：巨超龙 李勇 JU Chao-long LI Yong(Dept. of TCM Surgery ,Tongchuan Mining Bureau Central Hospital, Tongchuan ,Shaanxi 727000 Dept. of Chinese Medicine, Tongchuan Mining Bureau Central Hospital, Tongchuan ,Shaanxi 727000)

机构地区：[1]陕西铜川矿务局中心医院中医外科,陕西铜川727000 [2]陕西铜川矿务局中心医院中医内科,陕西铜川727000

出　　处：《中国肛肠病杂志》2017年第5期18-20,共3页Chinese Journal of Coloproctology

摘　　要：为探讨手术联合中药湿敷治疗急性嵌顿性混合痔的疗效,将72例急性嵌顿性混合痔患者随机分为观察组和对照组,各36例.观察组予保留肛垫的断桥缝合加内括约肌侧切术,术前24 h及术后予中药湿敷;对照组行外剥内扎术治疗.对比2组患者总体疗效、住院时间、创口愈合时间、术后创缘水肿程度及肛门疼痛程度、并发症和后遗症发生率、肛管直肠测压情况和复发率.结果显示,2组总有效率均为100%,差异无统计学意义,P〉0.05;但观察组治愈率（91.7%）明显高于对照组（75.0%）,P〈0.05.而且观察组住院时间和创面愈合时间明显短于对照组,术后肛门疼痛评分、术前及术后第7天肛缘水肿评分均明显低于对照组,术后并发症和后遗症发生率均明显低于对照组,P〈0.05或P〈0.01.2组术后肛管直肠测压结果及复发率比较,差异无统计学意义,P〉0.05.结果表明,保留肛垫的断桥缝合加内括约肌侧切术配合中药湿敷治疗急性嵌顿性混合痔疗效确切,患者术后痛苦小,恢复快,临床应用价值高.In order to explore the effect of surgery combined wet dressing of Chinese drug in the treatment of acute incarcerated mixed hemorrhoids, 72 patients with acute incarcerated mixed hemorrhoids were randomly divided into observation group and control group,36 cases for each.The observation group was treated with the disconnected skin flap bridge suture and reserving anal cushion plus internal sphincter lateral incision and given wet dressing of Chinese drug at the 24 h before surgery and after surgery.The control group accepted the external dissection and internal ligation for treatment.The total curative effect, hospitalization time, wound healing time, postoperative ano-edge edema and anal pain degree,the incidence of complications and sequelae, anorectal pressure and recurrence rate of the two groups were compared.As results, the total effective rate of the two groups was 100%, there was no statistical difference （P〉0.05）;but the curative rate of the observation group （91.7%） was significantly higher than that of the control group （75.0%, P〈0.05）.And in the hospitalization time and wound healing time the observation group was significantly shorter than the control group.In the postoperative anal pain score,at the 7th day of pre-operation and post-operation anal edema score, the observation group was significantly lower than the control group.In the postoperative complications and sequelae, the observation group was significantly lower than the control group（P〈0.05 or P〈0.01）.About the comparison of anorectal pressure measurement and the recurrence rate, there was no statistical difference（P〉0.05）.The results showed that the method used in the observation group in the treatment of acute incarcerated mixed hemorrhoids has certain effect, less pain after surgery and fast recovery.It has high clinical application value.

关 键 词：急性嵌顿痔 保留肛垫 断桥缝合术 内括约肌侧切术 中药湿敷 效果 

分 类 号：R657.18[医药卫生—外科学]