大黄制剂在肛周脓肿患者术后中的应用效果  

Postoperative application of rhubarb preparation in patients with perianal abscess

作　　者：林剑鹏 沈卫星 崔恒官 LIN Jianpeng;SHEN Weixing;CUI Hengguan(Department of General Surgery,Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University,Shanghai 201700)

机构地区：[1]复旦大学附属中山医院青浦分院普外科,上海201700

出　　处：《河北中医》2024年第7期1116-1119,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：上海市中西医结合学会社区医学与健康管理研究基金项目(编号:SQ17)。

摘　　要：目的探讨大黄制剂在肛周脓肿患者术后中的应用效果。方法将80例肛周脓肿患者随机数字表法分为2组,2组均予以肛周脓肿切开引流术治疗,在此基础上对照组40例予以常规处理,研究组40例在对照组基础上给予大黄制剂治疗。统计术后1周2组疗效、创面菌群情况,分析术前、术后1周2组炎症指标血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及降钙素原(PCT)情况,于术后1、7 d评估2组术后疼痛及创面渗液情况。结果研究组总有效率97.50%高于对照组85.00%(P<0.05);术后1周研究组创面存在大肠埃希菌比例低于对照组(P<0.05);术后1周2组血清IL-6、TNF-α、PCT水平低于治疗前(P<0.05),且术后1周研究组血清IL-6、TNF-α、PCT水平低于对照组(P<0.05);术后7 d 2组视觉模拟评分法(VAS)评分、创面渗液评分低于术后1 d(P<0.05),且术后7 d研究组VAS评分、创面渗液评分低于对照组(P<0.05)。结论大黄制剂应用于肛周脓肿患者术后,可减少创面菌群,减轻患者炎症反应,缓解术后疼痛,改善创面渗液,整体提高治疗效果。Objective To investigate the effect of postoperative application of rhubarb preparation in patients with perianal abscess.Methods A total of 80 patients underwent incision and drainage of perianal abscess were randomly divided into the control group(n=40)and study group(n=40).All patients were given routine treatment,those in the study group were additionally given rhubarb preparation.A 1-week treatment was performed,aiming to compare inter-group curative effect and wound microflora,inflammatory responses(serum interleukin-6[IL-6],tumor necrosis factor-α[TNF-α],and procalcitonin[PCT])before operation and on week 1,as well as the scores of visual analogue scale(VAS)and wound exudation in both groups on days 1 and 7.Results The total effective rate of the study group was significantly higher than that of the control group(97.50%vs 85.00%,P<0.05).The proportion of Escherichia coli in the wounds on week 1 in the study group was significantly lower than that of the control group(P<0.05).The levels of serum IL-6,TNF-α,PCT in the both groups on week 1 were significantly lower than those before treatment(P<0.05),and which in the study group were significantly lower than those in the control group(P<0.05).The VAS score and wound exudate score in the both groups on day 7 were significantly lower than those on day 1(P<0.05),and the VAS score and wound exudate score on day 7 in the study group were significantly lower than those of the control group(P<0.05).Conclusion The postoperative application of rhubarb preparation can decrease postoperative wound flora,reduce inflammatory response,relieve postoperative pain,improve wound exudation,and improve overall treatment effect in patients with perianal abscess.

关 键 词：肛周脓肿 肛周脓肿切开引流术 大黄制剂 创面菌群 炎性反应 创面渗液 

分 类 号：R266[医药卫生—中医外科学]