石蜡油在混合痔手术中的应用效果分析  

Analysis of the application effect of paraffin oil in mixed hemorrhoids surgery

作　　者：高丕尧[1] 马辉[2] 张成[3] 龚智鑫 秦伟夫[1] 韦建宝[1] Gao Piyao;Ma Hui;Zhang Cheng;Gong Zhixin;Qin Weifu;Wei Jianbao(Department of Gastrointestinal and Anal Surgery,Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nan⁃ning 530011,Guangxi Zhuang Autonomous Region,China;Department of Colorectal and Anal Surgery,First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China;Department of Neurosurgery,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Zhuang Au⁃tonomous Region,China)

机构地区：[1]广西中医药大学附属瑞康医院胃肠肛门外科,广西南宁530011 [2]广西医科大学第一附属医院结直肠肛门外科,广西南宁530021 [3]广西医科大学第一附属医院神经外科,广西南宁530021

出　　处：《结直肠肛门外科》2023年第4期368-372,共5页Journal of Colorectal & Anal Surgery

摘　　要：目的分析石蜡油在混合痔手术中的应用效果。方法回顾性分析2021年1月至2022年12月广西中医药大学附属瑞康医院收治的267例混合痔手术患者的临床资料,根据围手术期采用或不采用石蜡油作为缓泻剂,分为石蜡油组(n=125,围手术期采用石蜡油作为缓泻剂)和非石蜡油组(n=142,围手术期不采用石蜡油作为缓泻剂——以生理盐水作为对比剂)。比较两组血清电解质(钾、钠、钙、镁)水平差值(差值=术前1天数值-术后第5天数值)、住院时间、住院费用、追加使用同种镇痛药物或配置镇痛微泵的患者比例、术后首次排粪时间和术后首日排粪次数,比较两组及同一组不同手术方式的血红蛋白丢失量、术后首日术口疼痛情况和术后首次排粪时术口疼痛情况。结果两组术前1天与术后第5天血清电解质(钾、钠、钙、镁)水平差值、住院时间、术后首日术口疼痛VAS评分、术后首日排粪次数比较差异均无统计学意义(均P>0.05);石蜡油组的血红蛋白丢失量、住院费用较非石蜡油组少,追加使用同种镇痛药物或配置镇痛微泵的患者比例低于非石蜡油组(28%vs.47%),术后首次排粪时术口疼痛VAS评分低于非石蜡油组,术后首次排粪时间早于非石蜡油组,差异均有统计学意义(均P<0.05)。石蜡油组中,TST的血红蛋白丢失量较外剥内扎术少(P<0.05);不同手术方式的术后首日术口疼痛VAS评分、术后首次排粪时术口疼痛VAS评分比较差异均无统计学意义(均P>0.05)。非石蜡油组中,不同手术方式的血红蛋白丢失量、术后首日术口疼痛VAS评分比较差异无统计学意义(P>0.05),但TST的术后首次排粪时术口疼痛VAS评分低于外剥内扎术(P<0.05)。结论石蜡油在混合痔手术中具有良好的应用效果,可以缩短混合痔手术患者术后首次排粪时间,减少住院费用,降低追加使用同种镇痛药物或配置镇痛微泵的患者比例;同时可以减轻�Objectives To analyze the application effect of paraffin oil in mixed hemorrhoids surgery.Methods We retrospec⁃tively reviewed the clinical data of 267 mixed hemorrhoids patients treated at Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from January 2021 to December 2022.Patients were categorized based on their perioperative laxative use in⁃to two groups:the paraffin oil group(n=125)where paraffin oil was used,and the non-paraffin oil group(n=142)where physiolog⁃ical saline served as a control.We compared various metrics between the two groups,including:(1)Changes in serum electrolyte levels(potassium,sodium,calcium,magnesium)from the day before surgery to the 5th postoperative day;(2)Duration of hospital⁃ization and associated costs;(3)The proportion of patients requiring additional analgesic drugs or the setup of analgesic infusion pumps;(4)The time of first defecation after surgery and the frequency of defecation on the first postoperative day.Additionally,we assessed the variations in hemoglobin loss,the intensity of pain at the incision site on the first day after surgery and the first bowel movement post-surgery.These were compared both across the two main groups and within them based on the surgical techniques employed.Results No significant differences(P>0.05)were observed between the two groups in terms of serum elec⁃trolyte levels(potassium,sodium,calcium,magnesium)from the day before surgery to the 5th postoperative day,duration of hospi⁃talization,postoperative incision pain visual analog scale(VAS)score on the first day,and the frequency of defecation on the first postoperative day.However,the paraffin oil group showcased reduced hemoglobin loss,lower hospitalization expenses,and fewer patients requiring additional analgesic drugs or infusion pumps setups(28%in paraffin oil groups vs.47%in the non-paraffin oil groups),This group also reported less pain during the first post-surgery bowel movement and a quicker first postoperative defecation,with both findings being

关 键 词：混合痔 石蜡油 手术 临床疗效 

分 类 号：R657.1[医药卫生—外科学]