肛门肿痛熏洗液治疗痔疮术后常见并发症的临床研究

发布时间：2018-03-05 19:25

本文选题：痔疮　切入点：术后并发症　出处：《西南医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:探讨肛门肿痛熏洗液在痔术后并发症患者治疗中的安全性和有效性,为促进中医药的现代化发展和更好的指导临床,为痔术后并发症的治疗提供一定的理论基础。方法:选取我院肛肠科住院部2014年6月-2015年6月符合纳入标准、排除标准,且病历资料完整的行混合痔外剥内扎手术治疗的患者60例,依据随机平均分组原则分为两组,治疗组30例患者于常规术后治疗的基础上用肛门肿痛熏洗液行肛部熏洗治疗(20min/次,1次/日,连续治疗7天),对照组30例患者于常规术后治疗的基础上用高锰酸钾溶液(1∶5000)行肛部熏洗治疗(20min/次,1次/日,连续治疗7天),入组患者于熏洗治疗前后行三大常规(血、大便、尿)及肝、肾功能检查各一次,记录患者的创面完全愈合时间、水肿消退时间、不良反应发生情况,依据《中药新药临床研究指导原则(2002版)》评定入组患者熏洗治疗前及熏洗治疗后第4、7天肛门出血、坠胀、疼痛、水肿等并发症情况,采用SPSS20.0软件包对收集的数据进行统计学分析,计数资料用百分率(%)表示,两组间比较采用卡方检验;计量资料用(均数±标准差)表示,组间比较采用t检验,组内治疗前后用配对t检验;等级资料采用Mann-Whitney U检验,P0.05时,则表示有统计学差异性。结果:(1)两组患者熏洗治疗前术后疼痛、出血、坠胀、水肿的总体评分接近(t=2.034,P0.05);熏洗治疗后,治疗组和对照组患者术后并发症总体评分均得到减轻(t=12.659,P0.05;t=10.554,P0.05),且治疗组优于对照组(t=8.354,P0.05)。(2)治疗组患者水肿平均消退时间、创面完全愈合时间均优于对照组(t=6.214,P0.05;t=7.554,P0.05)。(3)两组患者熏洗治疗前术后出血积分相当(t=2.089,P0.05);两组患者行熏洗治疗后术后出血均有所改善,且治疗组患者熏洗治疗后第4、7天术后出血积分小于对照组(t=8.895,P0.05;t=7.216,P0.05)。(4)两组患者熏洗治疗前术后坠胀积分相近(t=1.054,P0.05);两组患者行熏洗治疗后术后坠胀均有所改善,治疗组患者熏洗治疗后第4、7天术后坠胀积分小于对照组,但差异无统计学意义(t=1.651,P0.05;t=1.842,P0.05)。(5)两组患者熏洗治疗前术后疼痛积分相当(t=1.247,P0.05);两组患者行熏洗治疗后术后疼痛均有所改善,且治疗组患者熏洗治疗后第4、7天术后疼痛积分小于对照组(t=4.557,P0.05;t=4.389,P0.05)。(6)本研究入组60例患者,治疗前后三大常规(大便、血、尿)及肝、肾功能检查均正常,治疗期间未发生与熏洗治疗相关的显著异常。结论:肛门肿痛熏洗液可有效促进痔疮术后常见并发症的恢复,可考虑推广运用。
[Abstract]:Objective: to explore the safety and efficacy of anal swelling and pain fumigation lotion in the treatment of postoperative complications of hemorrhoids, so as to promote the modernization of traditional Chinese medicine and better guide clinical practice. Methods: the inpatient department of anorectal department in our hospital from June 2014 to June 2015 was selected to meet the inclusion criteria and exclude the criteria for the treatment of postoperative complications of hemorrhoids. In addition, 60 patients with mixed hemorrhoids treated by external exfoliation and internal ligation were divided into two groups according to the principle of random average grouping. In the treatment group, 30 patients were treated by anal fumigation with anus fumigation lotion on the basis of routine postoperative treatment. 30 patients in the control group were treated with potassium permanganate solution 1: 5 000 on the basis of routine postoperative treatment. The patients in the control group were treated with anus fumigation and washing for 20 min / time once a day for 7 days. The patients in the control group were treated with three major routine methods (blood, stool) before and after fumigation. Urine) and liver and kidney function were examined once each to record the time of complete wound healing, the time of edema receding, and the occurrence of adverse reactions. To evaluate the complications of anal bleeding, falling distension, pain, edema and so on before and after fumigation and washing therapy on the 7th day after fumigation, according to the guiding principles of clinical study of new Chinese medicine drugs (2002 edition). The data collected were analyzed by SPSS20.0 software package. The counting data were expressed by percentage. The comparison between the two groups was expressed by chi-square test, the measured data was expressed by (mean 卤standard deviation), and the comparison between groups was expressed by t test. Before and after treatment, the matched t test was used before and after treatment; when Mann-Whitney U test was used, there was significant difference between the two groups. Results the total score of pain, bleeding, falling distention and edema in the two groups before and after fumigation treatment was close to 2.034m (P0.05A); after fumigation treatment, there was no significant difference between the two groups. The overall scores of postoperative complications in the treatment group and the control group were all alleviated, and the average time of edema subsiding in the treatment group was better than that in the control group. The time of complete wound healing was better than that of the control group (P 6.214p 0.05N 7.554m P 0.05U. 3) the score of bleeding before and after fumigation treatment was equal to 2.089m P0.05in the two groups, and the postoperative bleeding was improved after fumigation and washing treatment in both groups, and there was no significant difference between the two groups. The postoperative bleeding score of the patients in the treatment group was lower than that in the control group on the 7th day after fumigation. However, there was no significant difference between the two groups in terms of postoperative pain score before and after fumigation treatment, and the postoperative pain scores in the two groups were similar before and after fumigation treatment, and the postoperative pain was improved in both groups, but there was no significant difference between the two groups after fumigation and washing treatment, but there was no significant difference between the two groups in terms of postoperative pain after fumigation and washing treatment, but there was no significant difference between the two groups in terms of postoperative pain after fumigation and washing, and there was no significant difference between the two groups before and after fumigation. The postoperative pain score in the treatment group was lower than that in the control group on the 4th day after fumigation and washing. The scores of pain in the treatment group were lower than those in the control group. Conclusion: anal swelling and pain fumigation lotion can effectively promote the recovery of common complications after hemorrhoids operation.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R266

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