自动弹力线痔疮套扎术联合外痔切除保留齿状线术对混合痔患者围手术期指标及术后恢复的影响  

Effect of Ruiyun Procedure for Hemorrhoid Combined with External Hemorrhoidectomy with Preservation of Dentate Line on Perioperative Indexes and Postoperative Recovery of Patients with Mixed Hemorrhoid

作　　者：何文涛 成志峰 伍毅 杨正库 李明堃 HE Wentao;CHENG Zhifeng;WU Yi;YANG Zhengku;LI Mingkun(Department of Gastrointestinal and Anorectal Surgery,Jingzhou Hospital of Traditional Chinese Medicine,Jingzhou 434000,China;不详)

机构地区：[1]荆州市中医医院胃肠肛肠外科,湖北荆州434000

出　　处：《中国医学创新》2024年第12期22-26,共5页Medical Innovation of China

摘　　要：目的:探讨混合痔患者应用自动弹力线痔疮套扎术联合外痔切除保留齿状线术的效果及对围手术期指标、术后恢复的影响。方法:选取2021年5月—2023年3月荆州市中医医院胃肠肛肠外科收治的混合痔患者120例为研究对象,按照随机数字表法分成观察组(n=60)、对照组(n=60)。对照组患者应用外剥内扎术,观察组患者应用自动弹力线痔疮套扎术联合外痔切除保留齿状线术。比较两组围手术期指标、术后疼痛程度[视觉模拟评分法(VAS)]、术前与术后1个月肛肠动力学指标[直肠静息压(RRP)、肛周最大收缩压(MSP)、直肠肛管抑制反射阈值(AIRT)]及术后并发症发生率。结果:观察组与对照组手术时间比较,差异无统计学意义(P>0.05),观察组术中出血量比对照组少,术后排便时间、创面愈合时间、住院时间均短于对照组,差异均有统计学意义(P<0.05);观察组术后4、24、48、72 h的VAS评分均低于对照组,差异均有统计学意义(P<0.05);术后1个月,两组MSP均较术前降低,且观察组低于对照组,RRP、AIRT均较术前升高,且观察组均高于对照组,差异均有统计学意义(P<0.05);观察组术后并发症总发生率(5.00%)低于对照组(18.33%),差异有统计学意义(P<0.05)。结论:自动弹力线痔疮套扎术联合外痔切除保留齿状线术治疗混合痔的效果满意,手术创伤小、术后恢复快、术后疼痛程度轻,可促进患者肛肠动力学恢复,且术后并发症少。Objective:To investigate the effect of Ruiyun procedure for hemorrhoid combined with external hemorrhoidectomy with preservation of dentate line in patients with mixed hemorrhoid and its influence on perioperative indexes and postoperative recovery.Method:A total of 120 patients with mixed hemorrhoid admitted to Department of Gastrointestinal and Anorectal Surgery,Jingzhou Hospital of Traditional Chinese Medicine from May 2021 to March 2023 were selected as the study objects,and they were divided into observation group(n=60)and control group(n=60)according to random number table method.The control group was treated with external stripping and internal ligation,and the observation group was treated with Ruiyun procedure for hemorrhoid combined with external hemorrhoidectomy with preservation of dentate line.Perioperative indexes,postoperative pain degree[visual analogue scale(VAS)],anorectal dynamic indexes[rectal resting pressure(RRP),maximum anal squeeze pressure(MSP),anorectal inhibitory reflex threshold(AIRT)]before and 1 month after surgery and incidence of postoperative complications were compared between the two groups.Result:There was no significant difference in operation time between the observation group and the control group(P>0.05).The intraoperative bleeding volume in the observation group was less than that in the control group,and the postoperative defecation time,wound healing time and hospital stay were shorter than those in the control group,the differences were statistically significant(P<0.05).VAS scores of the observation group at 4,24,48 and 72 h after surgery were lower than those of the control group,the differences were statistically significant(P<0.05).1 month after surgery,MSP in both groups were lower than those before surgery,and that in the observation group was lower than that in the control group,RRP and AIRT were higher than those before surgery,and those in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The

关 键 词：混合痔 自动弹力线痔疮套扎术 外痔切除保留齿状线术 围手术期 疼痛 肛肠动力学 

分 类 号：R657.18[医药卫生—外科学]