Ⅲ~Ⅳ度环状混合痔患者PPH术后发生排尿困难的影响因素  

Influencing factors of dysuria in patients with gradeⅢ~Ⅳcircumferential mixed hemorrhoids after PPH

作　　者：孙承宇[1] SUN Chengyu(Department of Anorectal Surgery,Shenyang Anorectal Hospital,Liaoning,Shenyang 110002,China)

机构地区：[1]辽宁省沈阳市肛肠医院肛肠外科,110002

出　　处：《河北医药》2021年第21期3283-3285,3289,共4页Hebei Medical Journal

摘　　要：目的分析Ⅲ~Ⅳ度环状混合痔患者吻合器痔上黏膜环切术(PPH)术后发生排尿困难的影响因素。方法回顾性分析2017年1月至2020年1月在肛肠外科接受PPH术治疗的Ⅲ~Ⅳ度环状混合痔患者102例,统计患者PPH术后排尿困难发生情况,设计基线资料填写表,填写患者的基线资料,纳入全部可能因素,经单因素及多因素分析找出Ⅲ~Ⅳ度环状混合痔患者PPH术后发生排尿困难的影响因素。结果102例Ⅲ~Ⅳ度环状混合痔患者PPH术后发生排尿困难29例,发生率为28.43%(29/102);发生与未发生排尿困难患者合并尿路感染、术中出血量、焦虑程度、术后1 d时视觉模拟评分法(VAS)评分、补液量比较差异有统计学意义(P<0.05);组间其他基线资料比较差异无统计学意义(P>0.05);Logistic回归分析显示,合并尿路感染、术中出血量多、重度焦虑、术后1 d时疼痛程度高、补液量多均是Ⅲ~Ⅳ度环状混合痔患者PPH术后发生排尿困难的影响因素(OR>1,P<0.05)。结论Ⅲ~Ⅳ度环状混合痔患者PPH术后发生排尿困难的风险较高,可能与合并尿路感染、术中出血量多、重度焦虑、术后疼痛程度高、补液量多有关,伴有上述风险因素的患者应引起重视,尽早干预。Objective To investigate the effects of To analyze the influencing factors of dysuria in patients with gradeⅢ~Ⅳcircumferential mixed hemorrhoids after PPH.Methods The clinical data of 102 patients with gradeⅢ~Ⅳcircumferential mixed hemorrhoids who underwent PPH in the Department of Anorectal Surgery,Shenyang Anorectal Hospital from January 2017 to January 2020 were retrospectively analyzed,the main baseline data of all patients were complete,the occurrence of dysuria in all patients after PPH was recorded,designed the baseline data filling form,filled in the baseline data of patients in detail,all possible factors were included,univariate analysis and multivariate analysis were used to find out the influencing factors of dysuria in patients with gradeⅢ~Ⅳcircumferential mixed hemorrhoids after PPH.Results In 102 patients with gradeⅢ~Ⅳcircumferential mixed hemorrhoids after PPH,29 cases had dysuria,the incidence was 28.43%(29/102);the patients with and without dysuria complicated with urinary tract infection,intraoperative blood loss,degree of anxiety,visual analogue scale(VAS)score 1 day after operation,volume of fluid replacement were compared,there was a statistical significant difference(P<0.05);there was no statistical significant difference in the comparison of other baseline data between the two groups(P>0.05);after Logistic regression analysis,the results showed that combined with urinary tract infection,more intraoperative blood loss,severe anxiety,high degree of pain 1 day after operation and more fluid infusion were the influencing factors of dysuria in patients with gradeⅢ~Ⅳcircumferential mixed hemorrhoids after PPH(OR>1,P<0.05).Conclusion The risk of dysuria after PPH is higher in patients with gradeⅢ~Ⅳcircumferential mixed hemorrhoids,which may be associated with urinary tract infection,more intraoperative blood loss,severe anxiety,higher postoperative pain and more fluid infusion,patients with the above risk factors should be paid attention to and intervened as soon as possib

关 键 词：环状混合痔 吻合器痔上黏膜环切术 排尿困难 尿路感染 术中出血量 焦虑 疼痛 

分 类 号：R657.18[医药卫生—外科学]