不同位置注射亚甲蓝合剂对痔患者术后疼痛及肛肠动力学的影响  

Effect of njection of Methylene Blue Mixture at Different Positions on Postoperative Pain and Anorectal Dynamics in Patients with Hemorrhoids

作　　者：崔冠敏 吕金波[1] 胡继莹 CUI Guan-min;LYU Jin-bo;HU Ji-ying(Huaiyin People's Hospital,Jinan,Shandong 250021)

机构地区：[1]济南市槐荫人民医院,山东济南250021

出　　处：《中国肛肠病杂志》2025年第2期62-64,共3页Chinese Journal of Coloproctology

基　　金：济南市卫生健康委员会科技发展计划项目(编号2023-2-171)。

摘　　要：目的:比较不同位置注射亚甲蓝合剂对痔患者术后镇痛效果及肛肠动力学指标的影响。方法:将2023年12月至2024年6月于我科拟行混合痔外剥内扎术治疗的100例混合痔患者随机分为2组,每组50例,一组手术结束时于外括约肌皮下部注射亚甲蓝合剂镇痛(A组),另一组于创缘的皮下注射亚甲蓝合剂镇痛(B组)。于术后第3天和第10天对2组患者进行疼痛评估及肛门直肠测压,并进行比较。疼痛评估采用视觉模拟评分(VAS)法。结果:术后第3天和第10天,2组患者VAS评分比较差异均无统计学意义(P>0.05)。术后第3天,A组括约肌静息压、括约肌最大压和排便直肠压均显著低于B组(P<0.05),术后第10天2组各压力指标比较差异均无统计学意义(P>0.05);组内比较,A组术后第10天各压力指标均较术后第3天明显提高(P<0.05),而B组术后第10天仅括约肌最大压较术后第3天明显提高(P<0.05),括约肌静息压和排便直肠压无明显变化(P>0.05)。结论:痔术后无论是外括约肌皮下部注射亚甲蓝合剂,还是创缘皮下注射亚甲蓝合剂,镇痛效果相当,但前者对肛肠动力学影响更大,建议局限于皮下注射,避免注射到括约肌。Objective To compare the effect of injection of Methylene blue mixture at different positions on postoperative analgesia and anorectal dynamic indexes in patients with hemorrhoids.Methods A total of 100 patients with mixed hemorrhoids in our department from December 2023 to June 2024 were randomly divided into two groups,50 cases in each group.One group received subcutaneous injection of Methylene blue mixture at the external sphincter for analgesia at the end of surgery(group A),and the other group was given subcutaneous injection of Methylene blue mixture at the wound edge for analgesia(group B).Pain assessment and anorectal manometry were performed on the 3rd and 1oth day after operation.Pain was assessed by visual analogue scale(VAS).Results There was no significant difference in VAS scores between the two groups on the 3rd and 10th day after operation(P>0.05).On the 3rd day after operation,the sphincter resting pressure,maximum sphincter pressure,and rectal pressure during defecation in group A were significantly lower than those in group B(P<0.05),and there was no significant difference in the pressure indexes between the two groups on the 10th day after operation(P>0.05).For intra-group comparison,all the pressure indexes in group A were significantly higher on the 1oth day after operation than on the 3rd day after operation(P<0.05),while only the maximum pressure of sphincter in group B was significantly higher on the 1oth day after operation than on the 3rd day after operation(P<0.05),and there was no significant change in the sphincter resting pressure and rectal pressure during defecation(P>0.05).ConclusionAAfter hemorrhoidectomy,whether injection of Methylene blue mixture into the subcutaneous part of the external sphincter or the subcutaneous part of the wound edge has similar analgesic effect,but the former has a greater effect on anorectal dynamics.Therefore,it is recommended to limit the injection to the subcutaneous part and avoid the injection into the sphincter.

关 键 词：混合痔 术后镇痛 亚甲蓝注射 注射部位 肛肠动力学 

分 类 号：R657.1[医药卫生—外科学]