运用自动弹力线痔疮套扎器（RPH-4）治疗环形混合痔的临床研究

发布时间：2018-04-27 23:28

本文选题：环形混合痔 + 自动弹力线痔疮套扎器　；参考：《辽宁中医药大学》2017年硕士论文

【摘要】：目的:观察运用自动弹力线痔疮套扎器(RPH-4)治疗环形混合痔的临床疗效,客观评价自动弹力线痔疮套扎器(RPH-4)在治疗环形混合痔中的应用价值。材料与方法:将2015年10月至2016年5月在辽宁省肛肠医院接受住院治疗的60例环形混合痔患者,按随机分组原则分为治疗组30例和对照组30例。治疗组运用自动弹力线痔疮套扎器(RPH-4),对照组采用外剥内扎术。两组患者术前、术后给予相同的处置。根据拟定的量化评分观察并记录两组患者的总体疗效、手术一般情况、近期术后并发症、远期复发情况和安全性指标。运用SPSS20.0统计软件进行分析。结果:1.两组患者的年龄、性别、病程、术前症状、外痔类型上均具有可比性。2.两组患者出院时总体疗效比较无统计学意义(p0.05),两组患者总体疗效有效率均为100%。3.在手术一般情况中,两组患者在手术时间、创面愈合时间、术后肛门平整度评分三方面比较中具有统计学意义(p0.05)。治疗组在手术时间、创面愈合时间方面短于对照组,治疗组在术后肛门平整度方面较对照组更平整。4.在术后近期并发症中,两组患者分别在术后第1、3、7天创面疼痛评分比较中有统计学意义(p0.05),治疗组在术后疼痛程度方面优于对照组。两组患者分别在术后第1周、第2周的急便感评分比较中有统计学意义(p0.05),治疗组在术后近期急便感的发生及程度上低于对照组。两组患者在术后第10天肛门狭窄评分比较中有统计学意义(p0.05),治疗组在术后近期肛门狭窄的发生和程度上低于对照组。两组患者在术后12天以内最严重时的出血评分、术后12天内最严重的肛周水肿评分和术后24小时以内排尿困难评分的比较中无统计学差异(p0.05),提示两组患者在术后出血、术后肛周水肿和术后排尿困难方面无明显差异。5.术后3个月随访,两组患者没有出现复发情况。6.两组患者在安全性指标方面未出现明显异常及不良反应。结论:1.两组手术方法对环形混合痔的治疗均安全、有效,术后3个月内均无复发。2.治疗组手术方法对环形混合痔的治疗相比对照组手术方法更加简便,提高术后肛门美观程度,缩短创面愈合时间。3.治疗组手术方法相比对照组可以缓解术后创面疼痛,减少术后近期急便感、肛门狭窄的发生。4.两组手术方法治疗环形混合痔在降低术后出血、肛周水肿和排尿困难方面无差异。
[Abstract]:Objective: to observe the clinical effect of RPH-4 in the treatment of circular mixed hemorrhoids, and to evaluate objectively the value of RPH-4 in the treatment of circular mixed hemorrhoids. Materials and methods: from October 2015 to May 2016, 60 patients with circular mixed hemorrhoids were divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with RPH-4, and the control group was treated with external exfoliation and internal ligation. Patients in both groups were given the same treatment before and after operation. To observe and record the overall curative effect, general operation, postoperative complications, long term recurrence and safety index of the two groups according to the quantitative score. SPSS20.0 statistical software was used to analyze. The result is 1: 1. Age, sex, course of disease, preoperative symptoms and types of external hemorrhoids were comparable between the two groups. There was no significant difference in the total curative effect between the two groups when discharged from hospital. The overall effective rate of the two groups was 100. 3. In general, there was significant difference between the two groups in the operation time, wound healing time and postoperative anal flatness score (P 0.05). The operative time and wound healing time in the treatment group were shorter than those in the control group, and the anal smoothness in the treatment group was more level than that in the control group. In the postoperative complications, the pain scores of the two groups were significantly higher than that of the control group on the 1st and 7th day after operation, and the pain degree of the treatment group was better than that of the control group. In the first week and the second week after operation, there was a significant difference between the two groups in the score of acute stool. The incidence and degree of the acute stool in the treatment group was lower than that in the control group. The scores of anal stenosis in the two groups were significantly higher than those in the control group on the 10th day after operation, and the incidence and degree of anal stenosis in the treatment group were lower than those in the control group. There was no significant difference between the two groups in the scores of bleeding within 12 days after operation, perianal edema in 12 days after operation and dysuria in 24 hours after operation, indicating that the two groups had bleeding after operation. There was no significant difference between perianal edema and dysuria after operation. Follow up 3 months after operation, the two groups of patients did not have recurrence. 6. There was no obvious abnormality and adverse reaction in safety index between the two groups. Conclusion 1. The two groups were safe and effective in the treatment of circular mixed hemorrhoids. There was no recurrence within 3 months after operation. Compared with the control group, the surgical treatment of circular mixed hemorrhoids in the treatment group was more simple, improved the aesthetic degree of anus and shortened the healing time of wound. Compared with the control group, the operation method in the treatment group can relieve the pain of the wound, reduce the shortness of the post operation, and the occurrence of anal stricture. 4. 4. There was no difference between the two groups in reducing postoperative bleeding, perianal edema and dysuria.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.18

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