地奥司明对肛瘘术后患者创面愈合及肛管动力学的影响

发布时间：2017-12-26 20:32

本文关键词：地奥司明对肛瘘术后患者创面愈合及肛管动力学的影响　出处：《医学综述》2016年24期 　论文类型：期刊论文

【摘要】：目的探讨地奥司明对肛瘘术后患者创面愈合及肛管动力学的影响。方法选取2013年7月至2015年4月武汉市第五医院收治的行肛瘘手术患者82例,按照随机数字法分为联合组和对照组,各41例。术后两组患者均常规止血,抗菌药物预防感染,对照组从术后1 d祛腐生肌软膏、凡士林软膏换药,每次2~3 g,每日2次,联合组在对照组基础上给予地奥司明片,每次1片(0.5 g),每日2次,连续用药1周。比较两组患者创面水肿情况、创面愈合时间、住院时间及术后肛门控便能力、排便时肛门疼痛指数;分别于手术前后检测两组患者肛管最大收缩压、肛管最长收缩时间、直肠静息压、肛管的静息压。结果联合组总有效率显著高于对照组[100.0%(41/47)比90.3%(37/47),P0.05];两组术后1、3、5、7 d创面水肿评分均呈下降趋势,联合组下降速度更快,两组在组间、时点间、组间·时点间交互作用差异有统计学意义(P0.01)。联合组创面愈合时间、住院时间显著短于对照组[(21.6±3.9)d比(27.3±6.5)d、(11.8±4.8)d比(14.7±3.3)d],术后肛门控便能力得分、肛门疼痛指数均显著低于对照组[(0.28±0.04)分比(0.31±0.07)分、(6.4±1.5)分比(8.1±2.3)分](P0.01)。治疗后7 d联合组后直肠静息压、肛管的静息压显著高于对照组[(2.9±0.3)mm Hg(1 mm Hg=0.133 k Pa)比(2.1±0.2)mm Hg、(14.9±0.8)mm Hg比(13.2±0.7)mm Hg](P0.01)。结论地奥司明能够促进肛瘘术后创面愈合,降低肛缘水肿,改善肛管动力学,提高术后控便能力,值得临床推广。
[Abstract]:Objective to investigate the effects of diosmin and anorectal motility in patients with wound healing after operation of anal fistula. Methods from July 2013 to April 2015, 82 patients who underwent anal fistula operation in the fifth hospital of Wuhan were randomly divided into combined group and control group, 41 cases in each group. After two groups of patients underwent conventional hemostasis, antibiotics to prevent infection, the control group from the 1 postoperative D Qufushengji ointment and vaseline ointment, G 2~3 each time, 2 times a day, the joint group in the control group were given Diosmin tablets, 1 tablets each time (0.5 g), 2 times daily for 1 weeks. Comparison of two groups of patients with wound edema, wound healing time, hospitalization time and postoperative anal continence, defecation, anal pain index; respectively before and after operation in two groups were detected with anal maximal systolic blood pressure, anallongestcontraction time, rectal resting pressure, anal resting pressure. Results the total efficiency of the combination group was significantly higher than the control group [100.0% (41/47) 90.3% (37/47), P0.05]; the two group after 1, 3, 5, 7 d wound edema scores decreased, combined group decreased faster in the two groups, between groups, between groups and time point of interaction there was statistically significant difference (P0.01). The combined group wound healing time, hospitalization time was significantly shorter than the control group [(21.6 + 3.9) than D (27.3 + 6.5), D (11.8 + 4.8) than D (14.7 + 3.3) d], postoperative anal continence scores, anal pain index were significantly lower than the control group [(0.28 + 0.04) than (0.31 + 0.07), (6.4 + 1.5) than (8.1 + 2.3)%] (P0.01). After 7 d, the resting rectal pressure and anal resting pressure of the combined group were significantly higher than those of the control group [(2.9 + 0.3) mm Hg (1 mm Hg=0.133 K Pa) than (2.1 + 0.2) mm Hg, (14.9 + 0.8) mm Hg ratio (13.2 13.2 0.7) of the Hg (L). Conclusion Diosmin can promote wound healing after operation of anal fistula, reduce anal edema, improve anorectal motility, improve postoperative continence, is worthy of promotion.
【作者单位】：武汉市第五医院痔瘘科;
【分类号】：R657.16
【正文快照】： 肛瘘是指分布于肛门周围的肉芽脓肿性管道,主要由内口、瘘管、外口组成。由于肛瘘外口的生长速度快,脓肿肉芽在未完全消失即发生愈合,导致脓肿出现反复性破裂,使病变部位形成大龄瘘管和外口,进而发展成复杂性肛瘘[1-2]。目前对于肛瘘的治疗的主要措施依然是手术,然后手术后创

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