亚甲蓝+罗哌卡因混合液肛周封闭对环状混合痔患者术后镇痛的效果  

Effect of Perianal Blockage with Methylthioninium+Ropivacaine Admixture on Postoperative Analgesia in Patients with Circular Mixed Hemorrhoids

作　　者：石羽 倪锐 王天赐 SHI Yu;NI Rui;WANG Tianci(Department of Proctology,Maanshan General Hospital of Ranger-Duree Healthcare,Maanshan 243000,China;不详)

机构地区：[1]德驭医疗马鞍山总医院肛肠科,安徽马鞍山243000 [2]德驭医疗马鞍山总医院肿瘤科,安徽马鞍山243000

出　　处：《中国医学创新》2025年第10期66-71,共6页Medical Innovation of China

摘　　要：目的:探讨亚甲蓝+罗哌卡因混合液肛周封闭对环状混合痔患者术后疼痛的影响。方法:回顾性选择2021年8月—2023年8月德驭医疗马鞍山总医院肛肠科收治的环状混合痔痔切除术患者72例。根据术后不同止痛方法将患者分为A组(术后采用亚甲蓝+罗哌卡因混合液切缘皮下联合基底部注射)、B组(术后采用复方盐酸利多卡因切缘皮下联合基底部注射),每组36例。比较两组术后肛门疼痛程度、肛缘水肿程度、肢体活动情况、舒适度、术后当晚睡眠情况及不良反应和导尿情况。结果:术后1、2、3 d,A组静息痛、运动痛视觉模拟评分法(VAS)评分均低于B组(P<0.05);A组术后前三次换药痛及排便痛VAS评分均低于B组(P<0.05);术后1、2、3 d,A组Bruggrmann舒适度量表(BCS)评分均高于B组(P<0.05);术后1、3、5 d,A组肢体活动评分均低于B组(P<0.05);术后1、3、5 d,A组肛缘水肿评分均低于B组(P<0.05);A组术后当晚睡眠情况优于B组(P<0.05);两组不良反应发生率、导尿率比较,差异均无统计学意义(P>0.05)。结论:亚甲蓝+罗哌卡因混合液肛周封闭可有效缓解环状混合痔患者术后肛门疼痛、肛缘水肿,提高患者术后舒适度及睡眠质量,有助于早期活动和快速康复。Objective:To explore the effect of perianal blockage with Methylthioninium+Ropivacaine admixture on postoperative pain in patients with circular mixed hemorrhoids.Method:A total of 72 patients with circular mixed hemorrhoids who underwent hemorrhoidectomy were admitted to Department of Proctology,Maanshan General Hospital of Ranger-Duree Healthcare from August 2021 to August 2023 were retrospectively selected.The patients were divided into group A(postoperative subcutaneously of the incision margin and basal part injection with Methylthioninium+Ropivacaine admixture)and group B(postoperative subcutaneously of the incision margin and basal part injection with Compound Lidocaine Hydrochloride)according to different postoperative analgesic methods,with 36 cases in each group.The degree of postoperative anal pain,the degree of perianal margin edema,limb activity,comfort level,sleep condition on the night after surgery and adverse reactions and catheterization were compared between the two groups.Result:1,2 and 3 d after surgery,the scores of visual analogue scale(VAS)of resting pain and movement pain in group A were lower than those in group B(P<0.05).The VAS scores of pain during the first three dressing changes and defecation pain after surgery in group A were lower than those in group B(P<0.05).1,2 and 3 d after surgery,the scores of the Bruggrmann comfort scale(BCS)in group A were higher than those in group B(P<0.05).1,3 and 5 d after surgery,the scores of limb activity in group A were lower than those in group B(P<0.05).1,3 and 5 d after surgery,the scores of perianal margin edema in group A were lower than those in group B(P<0.05).The sleep condition on the night after surgery in group A was better than that in group B(P<0.05).There were no significant differences in the incidence of adverse reactions and the catheterization rate between the two groups(P>0.05).Conclusion:Perianal blockage with Methylthioninium+Ropivacaine admixture can effectively relieve postoperative anal pain and perianal margin edema in pat

关 键 词：环状混合痔 预防性镇痛 亚甲蓝 罗哌卡因 

分 类 号：R657.1[医药卫生—外科学]