外痔剥离术联合铜离子电化学治疗术和后正中位肛门内括约肌部分离断术治疗老年患者混合痔的疗效分析  

Analysis of the curative effect of external hemorrhoid stripping combined with copper ion electrochemical therapy and posterior median internal anal sphincter partial disconnection in the treatment of mixed hemorrhoids in elderly patients

作　　者：张志刚 付红燕 徐卫卫 Zhang Zhigang;Fu Hongyan;Xu Weiwei(Traditional Chinese Medicine Hospital(Municipal Infectious Disease Hospital)ofHuangshi City,Huangshi,Hubei,435001,P.R.China)

机构地区：[1]湖北省黄石市中医医院(市传染病医院),湖北黄石435001

出　　处：《老年医学与保健》2022年第1期173-177,共5页Geriatrics & Health Care

基　　金：湖北省黄石市医疗卫生科技计划项目(2019A29)。

摘　　要：目的探讨外痔剥离术联合铜离子电化学治疗术和后正中位肛门内括约肌部分离断术治疗老年患者Ⅲ、Ⅳ度混合痔的临床疗效。方法选择2019年11月—2020年3月黄石市中医医院肛肠科收治的100例老年患者,随机分为对照组和观察组,每组50例。对照组采用外痔剥离术联合铜离子电化学治疗术治疗,观察组在对照组的基础上,联合后正中位肛门内括约肌部分离断术治疗。观察比较2组疗效、肛管动力学指标(肛管静息压、肛管最大收缩压)、手术相关指标(手术时间、术中出血量、术后12h VAS疼痛评分、术后住院时间以及创面愈合时间)以及术后复发率。结果观察组总有效率明显高于对照组(P<0.05);术后1个月,2组肛管动力学指标均显著低于术前(P<0.05),且观察组明显低于对照组;2组手术时间及术中出血量差异均无统计学意义(P> 0.05);观察组术后12h疼痛VAS评分、术后住院时间、创面愈合时间和术后复发率均明显低于(短于)对照组(P<0.05)。结论外痔剥离术联合铜离子电化学治疗术和后正中位肛门内括约肌部分离断术治疗老年患者Ⅲ、Ⅳ度混合痔的疗效肯定,可有效改善肛管功能及手术相关指标,降低复发率。Objective To explore the clinical efficacy of external hemorrhoid stripping combined with copper ion electrochemical therapy and posterior median internal anal sphincter partial disconnection in the treatment ofⅢandⅣdegree mixed hemorrhoids in the elderly. Methods A total of100 elderly patients who were admitted to the Department of Anus and Proctology of Traditional Chinese Medicine Hospital of Huangshi City from November2019 to March2020 were selected and randomly divided into control group and observation group,with50 cases in each group. The control group was treated with external hemorrhoid stripping combined with copper ion electrochemical therapy,and the observation group was treated with posterior median internal anal sphincter partial disconnection on the basis of the control group. The curative effect,anal dynamic indexes(anal resting pressure and anal maximum systolic pressure),operation-related indexes(operation time,intraoperative bleeding,pain VAS score12 hours after operation,postoperative hospital stay and wound healing time)and postoperative recurrence rate were observed and compared between the two groups. Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.05). One month after the operation,the anal canal dynamics indexes of the two groups were significantly lower than those of the same group before the operation(P<0.05),and the anal canal dynamics indexes of the observation group was significantly lower than those of the control group(P<0.05). There was no significant difference in operation time and intraoperative blood loss between the two groups(P>0.05). The pain VAS score at12 hours after operation,postoperative hospital stay,wound healing time and postoperative recurrence rate of the observation group were significantly less(or shorter)than those of the control group(P<0.05). Conclusion External hemorrhoid stripping combined with copper ion electrochemical therapy and posterior median internal anal sphincter partial dis

关 键 词：老年 混合痔 外痔剥离术 铜离子电化学治疗术 后正中位肛门内括约肌部分离断术 疗效分析 

分 类 号：R657.18[医药卫生—外科学]