混合痔切除后残段缝合包埋对环状混合痔患者的疗效和安全性分析  

Efficacy and Safety Analysis of Residual Suture Embedding after Mixed Hemorrhoidectomy in Patients with Circumferential Mixed Hemorrhoids

作　　者：陈涛 林周 欧强 牛秀德 王振宇 欧佳宇 CHEN Tao;LIN Zhou;OU Qiang;NIU Xiude;WANG Zhenyu;OU Jiayu(Department of Anus and Intestines,Huishan District Third People's Hospital,Wuxi,Jiangsu Province,214183 China;Department of Gastrointestinal Surgery,Affiliated Hospital of Jiangnan University,Wuxi,Jiangsu Province,214183 China;Department of Anus and Intestines,Affiliated Hospital of Jiangnan University,Wuxi,Jiangsu Province,214183 China;Department of Anorectology,Huishan District People's Hospital,Wuxi,Jiangsu Province,214183 China)

机构地区：[1]江苏省无锡市惠山区第三人民医院肛肠科,江苏无锡214183 [2]江南大学附属医院胃肠外科,江苏无锡214183 [3]江南大学附属医院肛肠科,江苏无锡214183 [4]惠山区人民医院肛肠科,江苏无锡214183

出　　处：《中外医疗》2023年第28期47-51,共5页China & Foreign Medical Treatment

摘　　要：目的研究混合痔切除后残段缝合包埋对环状混合痔患者的治疗效果及安全效应。方法随机选取2022年7月—2023年7月无锡市惠山区第三人民医院收治的120例环状混合痔患者为研究对象,采用随机数表法分为观察组和对照组,每组60例。对照组行常规外剥内扎术治疗,观察组以放射状线型切口完成痔核剥离切除后,将混合痔残段于创面处包埋并对切口行锁边缝合。比较两组患者治疗效果、康复情况、相关评分、并发症发生率及3个月内复发率等。结果观察组治疗有效率为93.33%高于对照组,差异有统计学意义(χ^(2)=4.386,P<0.05);观察组创面愈合时间、总体住院时间短于对照组,差异有统计学意义(P<0.05);观察组术后1 d、3 d的创面视觉模拟评分、肛缘水肿评分低于对照组,差异有统计学意义(P<0.05)。观察组术后7 d的肛门感觉功能、闭合功能、控便功能评分低于对照组,差异有统计学意义(P<0.05);两组患者术后并发症发生率、3个月内复发率比较,差异无统计学意义(P>0.05)。结论混合痔切除后行残段缝合包埋处理可有效提升环状混合痔患者的治疗效果,缩短康复时间,减轻创面疼痛和肛缘水肿,对肛门功能修复亦有积极作用,对患者安全性和疾病复发无不良影响,值得推广研究。Objective To study the therapeutic effect and safety effect of residual suture embedding after mixed hemorrhoidectomy on patients with circumferential mixed hemorrhoids.Methods A total of 120 patients with circumferential mixed hemorrhoid admitted to the Huishan District Third People's Hospital from July 2022 to July 2023 were randomly selected as the study objects,and were divided into observation group and control group by random number table method,with 60 cases in each group.The control group was treated with conventional external peeling and internal ligation,and the observation group was treated with radial linear incision to complete hemorrhoidal stripping and resection,and then the mixed hemorrhoidal stump was embedded in the wound and the incision was closed with locking suture.Comparison of the two groups treatment effect,rehabilitation,related scores,complication rate and recurrence rate within 3 months.Results The treatment effectiveness rate of the observation group was 93.33%,which was higher than that of the control group,and the difference was statistically significant(χ^(2)=4.386,P<0.05).The wound healing time and overall hospitalization time of the observation group were shorter than that of the control group,and the difference was statistically significant(P<0.05).The trauma visual analog scoring method scores and anal margin edema scores of the observation group were lower than those of the control group in 1 d and 3 d postoperatively,and the differences were statistically significant(P<0.05).The anal sensory function,closure function,and stool control function scores of the observation group were lower than those of the control group in the 7d postoperative period,and the difference was statistically significant(P<0.05).There was no significant difference in postoperative complication rate and recurrence rate within 3 months between two groups(P>0.05).Conclusion Mixed hemorrhoidectomy after residual segment suture embedding treatment can effectively enhance the treatment effect of patients w

关 键 词：环状混合痔 放射状线型切口 残段包埋 锁边缝合 治疗效果 临床症状 

分 类 号：R657[医药卫生—外科学]