吻合器痔上粘膜环切术联合外痔切除术后创面水肿及慢性疼痛发生的相关因素分析  

Analysis of the related factors of wound edema and chronic pain after anastomat superior hemorrhoidectomy combined with external hemorrhoidectomy

作　　者：胡志凯 吕斌政 林恒军 HU Zhikai;LYU Binzheng;LIN Hengjun(Jinhua People's Hospital,Zhejiang 321000,China)

机构地区：[1]浙江省金华市人民医院,金华321000

出　　处：《浙江创伤外科》2025年第4期605-608,共4页Zhejiang Journal of Traumatic Surgery

摘　　要：目的探讨吻合器痔上粘膜环切(procedure for prolapse and hemorrhoids,PPH)联合外痔切除术治疗混合痔后患者出现肛缘水肿、慢性疼痛的危险因素,为临床预防相关并发症提供指导建议。方法选取本院2020年1月至2022年12月采用吻合器手术切除治疗的混合痔患者300例进行临床研究,根据患者术后是否并发肛缘水肿、慢性疼痛将患者分别进行分组,对比各组患者的一般资料、手术情况及术后康复资料,分析引起肛缘水肿、慢性疼痛的危险因素。结果300例吻合器手术切除治疗的混合痔患者,其中发生肛缘水肿67例,未发生肛缘水肿233例,肛缘水肿患者的高血压占比、肥胖占比、便秘占比大于非水肿组,差异具有统计学意义(P<0.05);Logistic回归模型分析结果:合并肥胖、合并便秘、是发生肛缘水肿的独立危险因素(P<0.05)。300例吻合器痔切除手术切除的患者,其中发生慢性疼痛34例,未发生慢性疼痛266例,慢性疼痛组年龄≥65岁占比、糖尿病占比、肥胖占比、便秘占比的患者占比大于非慢性疼痛患者,差异具有统计学意义(P<0.05);Logistic回归模型结果显示:合并肥胖、合并便秘是发生慢性疼痛的独立危险因素(P<0.05)。结论肥胖、合并便秘会增大混合痔患者吻合器手术切除联合外痔切除术治疗后发生肛缘水肿的风险,合并肥胖、合并便秘会增大其发生慢性疼痛的风险。Objective To investigate the risk factors of anal edema and chronic pain in patients with mixed hemorrhoids treated by procedure for prolapse and hemorrhoids(PPH)combined with external hemorrhoidectomy,and to provide guidance and suggestions for clinical prevention of related complications.Methods A clinical study was conducted on 300 patients treated with stapler surgery for mixed hemorrhoids in our hospital from January 2020 to December 2022.Patients were divided into groups based on whether they had postoperative anal edge edema and chronic pain.The general information,surgical situation,and postoperative rehabilitation data were compared,and the risk factors causing anal edge edema and chronic pain were analyzed.Results Among the 300 mixed hemorrhoid patients treated with stapler surgery,67 had anal edge edema.The proportion of hypertensive,obese,and constipation in the anal edge edema group was higher than that in the non edema group,and the differences were statistically significant(P<0.05).The logistic regression model analysis showed that obesity,constipation,and other factors were independent risk factors for the occurrence of anal edema(P<0.05).There were 34 patients had chronic pain after surgery.In the chronic pain group,the portions of age>65 years,diabetes,obese,constipation in the chronic pain group were greater than those in the non chronic pain group,with a statistically significant difference(P<0.05).The results of the logistic regression model showed that obesity,constipation,and mixed hemorrhoids were independent risk factors for chronic pain in patients(P<0.05).Conclusion Obesity combined with constipation will increase the risk of anal edema in patients with mixed hemorrhoids after stapler surgical resection combined with external hemorrhoidectomy,and obesity combined with constipation will increase the risk of chronic pain.

关 键 词：吻合器 切除 混合痔 肛缘水肿 慢性疼痛 危险因素 

分 类 号：R657.1[医药卫生—外科学]