家庭换药模式在混合痔外剥内扎术后创面愈合中的应用  

The Family-Centered Dressing Change Model on Wound Management after Milligan-Morgan Hemorrhoidectomy for Mixed Hemorrhoids

作　　者：陈启 翁和语 张伟伟 CHEN Qi;WENG He-yu;ZHANG Wei-wei(Department of Colorectal and Anal Surgery,Sir Run Run Hospital of Nanjing Medical University,Nanjing 211000,China)

机构地区：[1]南京医科大学附属逸夫医院结直肠肛门外科,南京211000

出　　处：《实用临床医学(江西)》2025年第1期30-33,38,共5页Practical Clinical Medicine

基　　金：南京市卫生科技发展专项资金项目(YKK24258)。

摘　　要：目的 探讨以家庭管理为中心的换药模式在混合痔外剥内扎术后创面愈合中的应用价值。方法 选择2022—2023年行外剥内扎术的混合痔患者96例,按出院后换药方式的不同将其分为观察组(47例,居家换药模式)和对照组(49例,传统的返院换药模式)。比较2组手术时长、住院时长、住院费用,出院后换药总次数、换药及复查费用,创面愈合时长,术后2周创面疼痛(视觉模拟评分法)、焦虑(广泛性焦虑量表)以及创面完全愈合后患者满意度(李克特量表)。结果 2组手术时长、住院时长、住院费用比较差异无统计学意义(P> 0.05)。观察组较对照组出院后换药及复查费用更少,疼痛评分更低(P <0.05);2组换药总次数、创面愈合时长、焦虑评分及患者满意度评分比较差异无统计学意义(P> 0.05)。结论 在混合痔外剥内扎术后的创面愈合中,采用以家庭管理为中心的换药模式,在不影响创面愈合的同时,有助于减少住院时长和就医频率,降低患者的医疗费用,且家庭环境可以减轻患者焦虑和不适,缓解其创面疼痛。Objective To explore the value of a family-centered dressing change model in wound healing after Milligan-Morgan hemorrhoidectomy for patients with mixed hemorrhoids.Methods A total of 96 patients who underwent Milligan-Morgan hemorrhoidectomy from 2022 to 2023 were selected as the study subjects and they were randomly divided into an observation group(47 cases)and a control group(49 cases)based on different dressing change models after discharge.The control group adopted a traditional hospital-based dressing change,while the observation group used a home-based dressing change.The operation duration,hospitalization duration,hospitalization costs,total number of dressing changes after discharge,dressing change and reexamination costs,wound healing duration,wound pain at 2 weeks postoperatively(assessed by the Visual Analog Scale),anxiety(assessed by the Generalized Anxiety Disorder Scale),and patient satisfaction after complete wound healing(assessed by the Likert scale)were compared between the 2 groups.Results There were no statistically significant differences in operation duration,hospitalization duration,and hospitalization costs between the 2 groups(P>0.05).Compared with the control group,the observation group had lower dressing change and reexamination costs,as well as a lower pain score(P<0.05).There were no statistically significant differences in the total number of wound dressings,wound healing duration,anxiety score,and patient satisfaction score between the 2 groups(P>0.05).Conclusion The family-centered dressing change model suggests positive value in the wound healing process for patients after Milligan-Morgan hemorrhoidectomy.It can help reduce hospitalization duration and frequency of hospital visits,lower medical costs,and alleviate patients’anxiety and discomfort,as well as relieve wound pain without affecting wound healing.

关 键 词：混合痔 外剥内扎术 创面愈合 家庭管理 换药模式 

分 类 号：R657.1[医药卫生—外科学]