结肠水疗与常规灌肠在混合痔TST术前肠道准备效果对比  

Comparison of effect of bowel preparation before TST between colon hydrotherapy and routine enema in patients with mixed hemorrhoid

作　　者：孟繁会[1] 

机构地区：[1]辽宁中医药大学附属第三医院,辽宁沈阳110003

出　　处：《结直肠肛门外科》2017年第5期615-618,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的比较混合痔选择性痔上黏膜吻合术(tissue-selecting therapy stapler,TST)术前结肠水疗与常规灌肠术前肠道准备的效果。方法选择2016年5月至2016年12月本院收治的140例择期TST术手术患者为研究对象,随机分为常规灌肠组组及肠道水疗组,每组各70例。常规灌肠组应用温生理盐水500~1000 mL,于术前晚7:00~8:00之间和术晨6:30~7:00之间各清洁灌肠4~5次和2~3次;结肠水疗组采用CL300型结肠水疗仪,于术前下午反复灌洗10~15次。比较两组操作时间、术中观察肠道清洁程度(术者反馈)、处理后腹胀程度(患者自评)。结果常规灌肠组平均操作时间为(95.31±12.89)min,结肠水疗组为(40.05±5.38)min,差异有统计学意义(P<0.05)。常规灌肠组肠道清洁总有效度为100.00%(70/70),结肠水疗组为60.00%(42/70),组间差异有统计学意义(P<0.05);两组肠道清洁程度总体效果差异有统计学意义(P<0.05)。两组术后重度、中度及轻度腹胀占比差异均有统计学意义(均P<0.05);两组术腹胀程度差异有统计学意义(P<0.05)。结论在混合痔TST术前肠道准备中,结肠水疗较常规灌肠相比更为简便、省时、安全、舒适,清洁更彻底。Objective To compare the effect of preoperative bowel preparation before tissue-selecting therapy stapler（TST） between colon hydrotherapy and routine enema in patients with mixed hemorrhoid. Methods 140 patients undergoing elective TST surgery from May to December 2016 in our hospital were randomly assigned to routine enema group and intestinal hydrotherapy group, with 70 cases in each group. The routine enema group received conventional warm saline of 500 - 1000 mL（4 - 5 times of cleansing enema between7：00 - 8：00 at the night before surgery and 2 - 3 times between 6：30 - 7：00 on the day of surgery. The colon hydrotherapy group received CL300 type colon hydrotherapy, with 10 - 15 times of preoperative repeated lavage at the afternoon of surgery. The operation time, degree of intestinal cleaning according to operator＇s feedback and the degree of abdominal distension after treatment according to patients＇ feedback were compared between groups. Results The average operation time in the routine enema group was（95.31 ±12.89） min, and in the colon hydrotherapy group was（40.05 ± 5.38） min, with statistically significant difference（P〈0.05）. Total effective rate in the routine enema group was 100%（70/70）, and in the colon hydrotherapy group was 60%（42/70）, with no significant difference between groups（P〈0.05）. There were significant differences between the two groups in overall intestinal cleanness（P〈0.05）. There were significant differences in the incidence of severe, moderate and mild abdominal distension between the two groups（P〈0.05）. The difference of abdominal distension between the two groups was statistically significant（P〈0.05）. Conclusion Compared with routine enema, colon hydrotherapy is more convenient, time-saving, safe, comfortable, and thorough in the preparation of bowel before TST.

关 键 词：TST 术前肠道准备 结肠水疗 常规灌肠 

分 类 号：R657.18[医药卫生—外科学]