吻合器痔上黏膜环形切除术对痔患者疼痛程度及并发症发生率的影响  

Effect of Procedure for Prolapse and Hemorrhoid on Pain Degree and Complication Rate of Patients with Hemorrhoids

作　　者：文洪 WEN Hong(Department of General Surgery,the Second People's Hospital of Guizhou Province,Guiyang 550000,China)

机构地区：[1]贵州省第二人民医院普外科,贵州贵阳550000

出　　处：《中国医学创新》2025年第5期111-114,共4页Medical Innovation of China

摘　　要：目的:分析吻合器痔上黏膜环形切除术(PPH)对痔患者的治疗效果。方法:选择2023年1月-2024年6月贵州省第二人民医院收治的60例痔患者,随机分成两组,各30例。对照组行外剥内扎术,观察组行PPH。对比两组手术相关指标、疼痛程度、应激反应、肛肠动力学、并发症发生情况。结果:观察组术中出血量为(14.26±1.48)mL,少于对照组的(20.35±2.39)mL,手术时间为(30.28±2.69)min、住院时间为(5.03±1.22)d,均短于对照组的(35.29±3.27)min、(9.71±2.03)d,差异均有统计学意义(P<0.05)。观察组术后3d的视觉模拟评分法评分为(3.01±0.42)分,前列腺素E2、皮质醇、促肾上腺皮质激素水平分别为(141.25±7.35)μg/L、(310.54±13.78)ng/mL、(76.44±4.09)pg/mL,均低于对照组的(3.89±0.71)分、(170.58±9.72)μg/L、(378.95±16.85)ng/mL、(95.83±5.21)pg/mL,差异均有统计学意义(P<0.05)。观察组术后1个月的肛管静息压为(58.52±3.53)mmHg、肛管最大收缩压为(118.48±8.32)mmHg,均低于对照组的(71.21±3.97)mmHg、(135.33±9.21)mmHg,直肠肛管抑制反射阈值为(38.77±4.21)mL,高于对照组的(29.85±3.60)mL,差异均有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:PPH有损伤小、术后恢复快等优势,可减轻痔患者术后疼痛,引起的应激反应较轻,且能促进患者肛肠动力学恢复。Objective:To analyze the therapeutic effect of procedure for prolapse and hemorrhoid(PPH)on patients with hemorrhoids.Method:A total of 60 patients with hemorrhoids admitted to the Second People's Hospital of Guizhou Province from January 2023 to June 2024 were randomly divided into two groups,with 30 cases in each group.The control group received external stripping and internal ligation,and the observation group received PPH.The operation related indexes,pain degree,stress response,anorectal dynamics and complications were compared between the two groups.Result:The intraoperative blood loss in the observation group was(14.26±1.48)mL,which was less than(20.35±2.39)mL in the control group,the operation time was(30.28±2.69)min and the hospitalization time was(5.03±1.22)d,which were shorter than(35.29±3.27)min and(9.71±2.03)d in the control group,the differences were statistically significant(P<0.05).The visual analogue scale score of observation group 3 days after operation was(3.01±0.42)scores,the levels of prostaglandin E2,cortisol and adrenocorticotropic hormone were(141.25±7.35)μg/L,(310.54±13.78)ng/mL and(76.44±4.09)pg/mL,respectively,which were lower than(3.89±0.71)scores,(170.58±9.72)μg/L,(378.95±16.85)ng/mL,(95.83±5.21)pg/mL of control group,the differences were statistically significant(P<0.05).The resting anal pressure and the maximum systolic pressure in the observation group were(58.52±3.53)mmHg and(118.48±8.32)mmHg 1 month after operation,which were lower than(71.21±3.97)mmHg and(135.33±9.21)mmHg in the control group,the anorectal inhibitory reflex threshold was(38.77±4.21)mL,which was higher than(29.85±3.60)mL in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:PPH has the advantages of small injury and quick postoperative recovery,which can reduce postoperative pain in patients with hemorrhoids,cause less stress response,and promote the recovery

关 键 词：痔 吻合器痔上黏膜环形切除术 并发症 

分 类 号：R657.18[医药卫生—外科学]