内痔套扎术联合外痔切除术对Ⅱ-Ⅳ期混合痔患者围术期指标、疼痛症状及肛肠动力学指标的影响  

The Effect of Internal Hemorrhoidectomy Combined with External Hemorrhoidectomy on Perioperative Indexes, Pain Symptoms and Anorectal Dynamic Indexes in Patients with Stage Ⅱ-Ⅳ Mixed Hemorrhoids

作　　者：佟瑶[1] 沈艺[1] 刘磊[1] 张译心 陈瑞超 TONG Yao;SHEN Yi;LIU Lei;ZHANG Yi-xin;CHEN Rui-chao(Department of Anorectal,Xuzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine,Xuzhou,Jiangsu,221003,China;Department of Anorectal Surgery,The Affiliated Hospital ofXuzhou Medical University,Xuzhou,Jiangsu,221004,China)

机构地区：[1]南京中医药大学附属徐州市中医院肛肠科,江苏徐州221003 [2]徐州医科大学附属医院肛肠外科,江苏徐州221004

出　　处：《现代生物医学进展》2020年第23期4522-4525,共4页Progress in Modern Biomedicine

基　　金：江苏省卫计委科研基金资助项目(N20160411)。

摘　　要：目的:探讨内痔套扎术联合外痔切除术对Ⅱ-Ⅳ期混合痔患者围术期指标、疼痛症状及肛肠动力学指标的影响。方法:选取2017年1月~2019年6月期间我院收治的95例Ⅱ-Ⅳ期混合痔患者,根据手术方式的不同分为对照组(n=44)和研究组(n=51),对照组给予外剥内扎术,研究组则给予内痔套扎术联合外痔切除术,比较两组患者围术期指标、疼痛症状评分、肛肠动力学指标及并发症发生情况。结果:研究组术中出血量少于对照组(P<0.05);手术时间、创面愈合时间、肛门疼痛消退时间短于对照组(P<0.05)。与术前比较,两组患者术后1、7、14 d视觉模拟评分量表(VAS)评分呈先升高后降低趋势(P<0.05),且研究组VAS评分低于对照组(P<0.05)。两组患者术后3个月肛管静息压、直肠最大耐受量、直肠感觉阈值、肛管最大收缩压均下降,且研究组低于对照组(P<0.05)。研究组术后并发症发生率低于对照组(P<0.05)。结论:内痔套扎术联合外痔切除术治疗Ⅱ-Ⅳ期混合痔患者,可有效改善患者围术期相关指标,改善患者疼痛症状及肛肠动力学指标,同时还可减少并发症发生率,临床应用价值较高。Objective: To investigate the effect of internal hemorrhoidectomy combined with external hemorrhoidectomy on perioperative indexes, pain symptoms and anorectal motility indexes of patients with stage Ⅱ-Ⅳ mixed hemorrhoids. Methods: 95 patients with stage Ⅱ-Ⅳ mixed hemorrhoids who were admitted to our hospital from January 2017 to June 2019 were selected, they were divided into control group(n=44) and study group(n=51) according to the different operation methods. The control group was treated with exfoliation and internal ligation, while the study group was treated with internal hemorrhoidectomy combined with external hemorrhoidectomy. The perioperative indexes, pain symptoms, anorectal motility indexes and complications of the two groups were compared. Results: The amount of bleeding in the operation was less than that in the control group(P<0.05). The operation time, wound healing time, anal pain relief time in the study group were shorter than those in the control group(P<0.05). Compared with preoperative,the visual simulation score(VAS) of the two groups increased first and then decreased on the 1, 7, 14 d after operation(P<0.05), and the VAS score of the study group was lower than that of the control group(P<0.05). The anorectal resting pressure, rectal maximum tolerance, rectal sensory threshold and anal maximum systolic pressure in the two groups decreased at 3 months after operation, and those in the study group were lower than those in the control group(P<0.05). The incidence of postoperative complications in the study group was lower than that in the control group(P<0.05). Conclusion: Internal hemorrhoidectomy combined with external hemorrhoidectomy can effectively improve the perioperative related indexes, improve the pain symptoms and anorectal dynamic indexes of patients, and reduce the incidence of complications, which has a higher clinical value.

关 键 词：内痔套扎术 外痔切除术 Ⅱ-Ⅳ期混合痔 围术期指标 疼痛症状 肛肠动力学 

分 类 号：R657.18[医药卫生—外科学]