RPH联合改良肛裂扩创术治疗环状混合痔合并肛裂疗效分析  

Efficacy Analysis of RPH Combined with Modified Anal Fissure Dilation in the Treatment of Annular Mixed Hemorrhoids with Anal Fissure

作　　者：刘晓晓 韩凯 LIU Xiaoxiao;HAN Kai(Department of Anorectal,Xuzhou Hospital of Traditional Chinese Medicine,Xuzhou,Jiangsu Province,221000 China)

机构地区：[1]江苏省徐州市中医院肛肠科,江苏徐州221000

出　　处：《中外医疗》2022年第28期52-56,共5页China & Foreign Medical Treatment

摘　　要：目的分析自动痔疮套扎术(RPH)+改良肛裂扩创术治疗环状混合痔合并肛裂的临床疗效。方法随机选取江苏省徐州市中医院肛肠科2019年1月—2021年1月住院的60例环状混合痔合并肛裂患者为研究对象,依照随机数表法分为两组,每组30例,对比组接受RPH+肛裂切除术治疗,观察组接受RPH+改良肛裂扩创术治疗,对比两组临床疗效、VAS评分、肛门切口水肿分级、肛管压力、创面愈合时间、并发症总发生率、QOL评分。结果观察组临床总有效率(96.67%)高于对比组(70.00%),差异有统计学意义(χ^(2)=7.680,P=0.006),观察组术后2周VAS评分低于对比组,差异有统计学意义(P<0.05)。观察组肛门切口水肿0级率(40.00%)、1级率(60.00%)均高于对比组(3.33%、33.33%),观察组2级率(0.00%)低于对比组(63.33%),差异有统计学意义(Z=30.593,P<0.001)。观察组术后3周肛管最大收缩压(151.26±6.92)mmHg、肛管静息压(58.62±6.62)mmHg、直肠静息压(6.45±1.02)mmHg均高于对比组(129.62±4.11)、(48.26±3.18)、(6.43±1.01)mmHg,差异有统计学意(P<0.05)。观察组创面愈合时间(21.62±3.67)d短于对比组(25.62±4.57)d,差异有统计学意义(P<0.05)。观察组并发症总发生率(3.33%)低于对比组(26.67%),差异有统计学意义(P<0.05)。观察组术后2周QOL评分高于对比组,差异有统计学意义(P<0.05)。结论RPH+改良肛裂扩创术可有效缓解环状混合痔合并肛裂患者疼痛、水肿等症状,促进创面愈合,降低并发症发生率,保护肛门功能。Objective To analyze the clinical effect of automatic hemorrhoid ligation(RPH)+modified anal fissure dilation in the treatment of annular mixed hemorrhoids with anal fissure.Methods Randomly selected the enrolled subjects were 60 patients with annular mixed hemorrhoids combined with anal fissure who were hospitalized in the Department of Anorectal,Xuzhou Hospital of Traditional Chinese Medicine,Jiangsu Province from January 2019 to January 2021,and were randomly divided into two groups,30 cases in each group.The control group received RPH+anal fissure resection,and the observation group received RPH+modified anal fissure expansion.The clinical efficacy,VAS score,anal incision edema grade,anal canal pressure,wound healing time,total incidence of complications,and QOL score were compared between the two groups.Results The clinical total effective rate(96.67%)of the observation group was higher than that of the control group(70.00%),and the difference was statistically significant(χ^(2)=7.680,P=0.006),and the VAS score of the observation group two weeks after operation was lower than that of the control group,and the difference was statistically significant(P<0.05).The rate of grade 0(40.00%)and grade 1(60.00%)of anal incision edema in the observation group were higher than those in the control group(3.33%,33.33%),and the rate of grade 2(0.00%)was lower than that in the control group(63.33%),and the difference was statistically significant(Z=30.593,P<0.001).The maximum anal systolic(151.26±6.92)mmHg,blood pressure(58.62±6.62)mmHg and anal canal resting pressure(6.45±1.02)mmHg in the observation group were higher than those in the control group(129.62±4.11)mmHg,(48.26±3.18)mmHg,(6.43±1.01)mmHg at 3 weeks after operation,and the difference was statistically significant(P<0.05).The wound healing time in the observation group(21.62±3.67)d was shorter than that in the control group(25.62±4.57)d,the difference was statistically significant(P<0.05).The total incidence of complications in the observation group(3.33

关 键 词：自动痔疮套扎术 改良肛裂扩创术 环状混合痔 肛裂 临床疗效 

分 类 号：R657.14[医药卫生—外科学]