曲安奈德肛周注射并中药坐浴防治混合痔外剥内扎术后肛门狭窄的疗效  

Effect of Triamcinolone Acetonide Perianal Injection Combined with Sitz Bath on Prevention and Treatment of Anal Stricture after External Stripping and Internal Ligation of Mixed Hemorrhoids

作　　者：肖彦燕 马丽丽 张美林 林秀红 XIAO Yanyan;MA Lili;ZHANG Meilin;LIN Xiuhong(Shaoguan Chinese Medicine Hospital,Shaoguan 512000,China;Dayuan Town Health Center,Lechang,Shaoguang City,Shaoguan 512000,China)

机构地区：[1]韶关市中医院,广东韶关512000 [2]韶关市乐昌大源镇卫生院,广东韶关512000

出　　处：《中国医药指南》2022年第23期1-4,共4页Guide of China Medicine

基　　金：2019年广东省中医药管理局基金资助项目(20191327)。

摘　　要：目的探讨曲安奈德肛周注射结合中药坐浴对混合痔外剥内扎术(M-M)后肛门狭窄等并发症的防治作用。方法最终纳入2018年1月至2021年6月符合纳入标准的93例混合痔M-M术患者,随机分为3组,对照1组31例,术后予醋酸曲安奈德注射液50 mg+0.5%盐酸罗哌卡因注射液10 mL肛周注射;对照2组29例,术后予1%亚甲蓝注射液1 mL+0.5%盐酸罗哌卡因注射液10 mL+0.9%氯化钠注射液10 mL肛周注射;治疗组33例,在对照1组基础上结合消肿止痛、收敛生肌中药坐浴2周。观察术后第1、3、7、14天伤口水肿、疼痛、便血、控便能力等指标,以及伤口愈合时间,术后第4、8、12周肛门狭窄程度,进行评分。结果术后12周,3组均实现100%治愈率。治疗组术后水肿、控便能力评分及肛门狭窄例数与对照1组相当,差异无统计学意义(P>0.05),但疼痛评分优于对照1组(P<0.05);术后伤口疼痛、水肿、控便能力评分以及肛门狭窄比例均优于对照2组(P<0.05)。对照1组术后水肿、控便能力评分及肛门狭窄比例优于对照2组(P<0.05),对照2组疼痛评分优于对照1组(P<0.05)。术后4周,3组患者伤口均愈合,治疗组的伤口愈合时间明显短于对照1组与对照2组(P<0.05)。术后12周,治疗组无肛门狭窄病例,对照1组共出现1例轻度狭窄,对照组2组先后出现6例轻度狭窄和1例中度狭窄,经处理均实现治愈。结论曲安奈德肛周注射结合中药坐浴对混合痔M-M术后肛门狭窄等并发症的防治疗效果显著。Objective To investigate the prevention and treatment of perianal injection of triamcinolone acetonide combined with sitz bath of traditional Chinese medicine on the complications of anal stenosis after mixed hemorrhoids external stripping and internal ligation(M-M).Methods A total of 93 patients with mixed hemorrhoid M-M who met the criteria from January to June 2018 were randomly divided into three groups:control group 1(n=31)received 50 mg triamcinolone acetonide acetate+0.5% ropivacaine hydrochloride injection 10 mL perianal injection;control group 2(n=29)received 1% methylene blue injection(1 mL)+0.5%ropivacaine hydrochloride injection(10 mL)+0.9% sodium chloride injection(10mL);treatment group(n=33)in the on the basis of the control group,the combination of detumescence and pain relief,astringent shengji Chinese medicine sitz bath for 2 weeks.The wound edema,pain,hematochezia,ability to control stool,wound healing time and anal stenosis were observed at 1,3,7 and 14 days after operation,and the degree of anal stenosis was evaluated at 4,8 and 12 weeks.Results After 12 weeks,all three groups achieved 100% cure rate.The postoperative edema,stool control ability scores and the number of cases of anal stenosis in the treatment group were similar to those in the control group 1,with no significant difference(P>0.05),but the pain score was better than that in the control group 1(P<0.05).The scores of edema,stool control ability and the number of cases of anal stenosis were better than those of the two control groups(P<0.05).The postoperative edema,stool control ability score and the number of cases of anal stenosis in the control group 1 were better than those in the control group 2(P<0.05),and the pain score in the control group 2 was better than that in the control group 1(P<0.05).Four weeks after operation,the wounds of the three groups were all healed,and the wound healing time of the treatment group was significantly shorter than that of the control group 1 and the control group 2(P<0.05).At 12 weeks after o

关 键 词：混合痔 肛门狭窄 曲安奈德肛周注射 中药坐浴 

分 类 号：R657.18[医药卫生—外科学]