本文選題：痔瘡 + 多普勒��； 參考：《大連醫(yī)科大學(xué)》2017年碩士論文

【摘要】：研究背景:使用常規(guī)痔瘡切除術(shù)治療痔瘡有顯著的發(fā)病率,主要的表現(xiàn)為手術(shù)后的疼痛及日�；顒�(dòng)的延遲。多普勒引導(dǎo)痔瘡動(dòng)脈血管結(jié)扎術(shù)是治療痔瘡侵入性最小的手術(shù),并可減少患者的不便。研究目的:分析多普勒引導(dǎo)痔瘡動(dòng)脈血管結(jié)扎術(shù)的最初結(jié)果與直腸黏膜治療痔瘡的關(guān)聯(lián)性。研究方法:從2015年12月至2016年8月分析了84例使用多普勒引導(dǎo)痔瘡動(dòng)脈血管結(jié)扎術(shù)(Doppler-guided hemorrhoidal artery ligation,DGHAL)治療的患者,包含了第II期,第III期和第IV期痔瘡患者。22例患者(26%)為第II期;42例患者(50%)為第III期;和20例患者(24%)為第IV期痔瘡患者。所有患者皆由相同的外科醫(yī)生在脊髓麻醉下使用相同的設(shè)備和技術(shù)進(jìn)行手術(shù)。這84位病患接受了連續(xù)縫合直腸黏膜術(shù)結(jié)扎6條動(dòng)脈分支。18名患者需要同時(shí)切除肛周贅肉。在術(shù)后,評(píng)估以下參數(shù):疼痛,里急后重感,出血,瘙癢,脫垂,黏液排出和復(fù)發(fā)。平均術(shù)后持續(xù)追蹤4個(gè)月。研究結(jié)果:85.7%的患者最常見(jiàn)的術(shù)后抱怨是有里急后重感,其次是疼痛占28.6%,肛門(mén)周?chē)鸁聘姓?2.3%,黏液分泌和肛門(mén)周?chē)[占4.7%。兩名患者出現(xiàn)嚴(yán)重的術(shù)后出血,需要手術(shù)止血,其中一位還需要輸血。95%的患者表示對(duì)此手術(shù)方式感到滿意。研究結(jié)論:盡管DGHAL具有與其他手術(shù)方法類(lèi)似的并發(fā)癥,但其結(jié)果顯示手術(shù)后疼痛較少,更快的復(fù)原和恢復(fù)工作。更多的病例和更長(zhǎng)的追蹤研究是必要的,以評(píng)估晚期復(fù)發(fā)。
[Abstract]:Background: conventional hemorrhoidectomy has a significant incidence of hemorrhoids. The main manifestations of hemorrhoidectomy are postoperative pain and delay in daily activities. Doppler-guided ligation of hemorrhoids artery is the least invasive operation for hemorrhoids and can reduce the inconvenience of patients. Objective: to analyze the relationship between the initial results of Doppler-guided hemorrhoids artery ligation and rectal mucosal treatment of hemorrhoids. Methods: from December 2015 to August 2016, 84 patients with Doppler guided hemorrhoid artery ligation (Doppler-guided hemorrhoidal artery ligation) were analyzed, including phase II. 22 patients with hemorrhoids in stage III and IV, 42 patients with stage II and 50 patients with III, and 20 patients with hemorrhoids of stage IV were diagnosed as patients with hemorrhoids of stage IV. All patients were operated by the same surgeon under spinal anesthesia using the same equipment and techniques. The 84 patients underwent continuous rectal mucosal suture and ligation of 6 arterial branches. 18 patients underwent simultaneous excision of perianal vegetations. After surgery, the following parameters are evaluated: pain, severe irritation, bleeding, itching, prolapse, mucus excretion, and recurrence. The average postoperative follow-up lasted 4 months. Results the most common postoperative complaints in 85.7% of the patients were acute and severe, followed by pain, perianal burning, and mucus secretion and perianal hematoma, accounting for 4.7% of the patients, followed by pain (28.6%), perianal burning (12.3%), mucus secretion and perianal hematoma (4.7%). Two patients suffered severe postoperative bleeding and needed surgery to stop the bleeding. One patient also needed a blood transfusion. 95 percent of the patients said they were satisfied with the procedure. Conclusion: although DGHAL has complications similar to other surgical procedures, the results show that there is less postoperative pain and faster recovery and recovery. More cases and longer follow-up studies are necessary to assess late recurrence.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R657.18

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