肿痛熏洗液治疗RPH联合外痔切除术后肛门疼痛及坠胀的临床研究

发布时间：2019-01-27 06:00

【摘要】：目的:观察肿痛熏洗液治疗RPH(自动痔疮套扎器术)联合外痔切除术后肛门疼痛、坠胀的临床疗效。方法:选取我院肛肠科2015年11月-2016年12月期间行RPH联合外痔切除术的住院病人80例,随机分为对照组和治疗组,两组患者术后常规治疗均相同,从术后第二天起每日均在肛周多功能熏洗仪上熏洗1次,每次30分钟,连续治疗7天,治疗组40例患者采用肿痛熏洗液,对照组40例患者采用0.02%的高锰酸钾溶液熏洗。记录治疗前及治疗后1、4、7天的肛门疼痛程度评分、肛门疼痛持续时间评分、肛门坠胀程度评分、肛门坠胀持续时间评分,以及肛门疼痛的消除时间、肛门坠胀消除时间。采用统计学软件SPSS21.0进行统计学分析,规定当P0.05时,则表示差异有统计学意义性。结果:(1)熏洗治疗后第1天,两组患者肛门疼痛程度、肛门疼痛持续时间、肛门坠胀程度、肛门坠胀持续时间均有一定的改善,但疗效不显著,差异无统计学意义(t=0.831,P0.05;t=0.871,P0.05;t=1.547,P0.05;t=2.71,P0.05)。(2)熏洗治疗后第4天,两组患者在肛门疼痛程度、肛门疼痛持续时间、肛门坠胀程度、肛门坠胀持续时间方面均有改善,且治疗组优于对照组,差异有统计学意义(t=2.327,P0.05;t=2.388,P0.05;t=4.33,P0.05;t=4.723,P0.05)。(3)熏洗治疗后第7天,两组患者肛门疼痛程度、肛门疼痛持续时间、肛门坠胀程度、肛门坠胀持续时间与熏洗治疗前相比均有明显改善,差异有统计学意义(所有P0.05);两组患者在这些方面相比较,治疗组明显优于对照组,差异有统计学意义(t=2.988,P0.05;t=3.576,P0.05;t=2.632,P0.05;t=4.985,P0.05)。(4)两组患者肛门疼痛、坠胀的消除时间相比较,治疗组均明显短于对照组,差异有统计学意义(t=2.688,P0.05;t=2.683,P0.05);同时治疗组在肛门疼痛、坠胀方面的临床疗效高于对照组,差异有统计学意义(Z=2.784,P0.05;Z=2.566,P0.05)。(5)本研究两组共80例患者,治疗前及治疗7天后的血常规、肝肾功均未见明显异常,治疗期间均未发生与熏洗治疗相关的严重不良反应。结论:肿痛熏洗液和0.02%高锰酸钾熏洗均能有效治疗RPH联合外痔切除术后的肛门疼痛、坠胀,且安全无副反应,但两种药物比较而言,肿痛熏洗液的临床疗效优于0.02%高锰酸钾。
[Abstract]:Objective: to observe the clinical effect of RPH (automatic hemorrhoids ligation) combined with anal pain and distension after external hemorrhoidectomy. Methods: 80 inpatients who underwent RPH combined external hemorrhoidectomy from November 2015 to December 2016 in our hospital were randomly divided into two groups: the control group and the treatment group. The two groups had the same routine treatment after operation. From the second day after operation, 40 patients in the treatment group were treated with swelling and pain fumigation solution, and 40 patients in the control group were fumigated by potassium permanganate solution with 0.02% potassium permanganate solution. The scores of anus pain degree, anus pain duration, anus drop distension, anus distention duration, anus pain elimination time and anus distension elimination time were recorded before and 1 ~ 4 ~ 7 days after treatment, and the results were as follows: (1) the anus pain score, the anus pain duration score, the anus distention duration score, the anus pain elimination time. The statistical software SPSS21.0 was used for statistical analysis. When P05 was specified, the difference was statistically significant. Results: (1) on the first day after fumigation, the degree of anal pain, the duration of anal pain, the degree of anus drop and the duration of anal distention were improved in both groups, but the curative effect was not significant. The difference was not statistically significant (t0. 831, P 0. 05; TX 0.871P0.05P0.05P0.05; On the 4th day after fumigation, the degree of anal pain, the duration of anal pain, the degree of anus fall and the duration of anal bloating were improved in both groups, and the treatment group was superior to the control group. The difference was statistically significant (t = 2.327, P 0.05). T ~ (2. 388) (P0.05) ~ (4) ~ (33) (P0.05); On the 7th day after fumigation and washing, the degree of anal pain, the duration of anal pain, the degree of anus drop and the duration of anus drop distention were significantly improved in both groups compared with those before fumigation. The difference was statistically significant (all P0.05); Compared with the control group, the treatment group was better than the control group in these aspects, and the difference was statistically significant (t = 2.988U, P 0.05, P = 3.576, P 0.05, P = 0.05a, P 0.05, P 0.05). Compared with the control group, the treatment group was significantly shorter than the control group (P < 0.05). The difference was statistically significant (P 0.05). At the same time, the clinical curative effect of the treatment group in anal pain and distension was higher than that in the control group (P 0.05). Two groups of 80 patients, blood routine before treatment and 7 days after treatment, liver and kidney function were not significantly abnormal, and there were no serious adverse reactions related to fumigation treatment during the treatment period. Conclusion: both swelling and pain fumigation lotion and 0.02% potassium permanganate fumigation can effectively treat anal pain and distention after RPH combined with external hemorrhoidectomy. The clinical effect of swelling and pain fumigation lotion was better than that of 0.02% potassium permanganate.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.18

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