【摘要】：目的:觀察腫痛熏洗液治療RPH(自動痔瘡套扎器術(shù))聯(lián)合外痔切除術(shù)后肛門疼痛、墜脹的臨床療效。方法:選取我院肛腸科2015年11月-2016年12月期間行RPH聯(lián)合外痔切除術(shù)的住院病人80例,隨機分為對照組和治療組,兩組患者術(shù)后常規(guī)治療均相同,從術(shù)后第二天起每日均在肛周多功能熏洗儀上熏洗1次,每次30分鐘,連續(xù)治療7天,治療組40例患者采用腫痛熏洗液,對照組40例患者采用0.02%的高錳酸鉀溶液熏洗。記錄治療前及治療后1、4、7天的肛門疼痛程度評分、肛門疼痛持續(xù)時間評分、肛門墜脹程度評分、肛門墜脹持續(xù)時間評分,以及肛門疼痛的消除時間、肛門墜脹消除時間。采用統(tǒng)計學軟件SPSS21.0進行統(tǒng)計學分析,規(guī)定當P0.05時,則表示差異有統(tǒng)計學意義性。結(jié)果:(1)熏洗治療后第1天,兩組患者肛門疼痛程度、肛門疼痛持續(xù)時間、肛門墜脹程度、肛門墜脹持續(xù)時間均有一定的改善,但療效不顯著,差異無統(tǒng)計學意義(t=0.831,P0.05;t=0.871,P0.05;t=1.547,P0.05;t=2.71,P0.05)。(2)熏洗治療后第4天,兩組患者在肛門疼痛程度、肛門疼痛持續(xù)時間、肛門墜脹程度、肛門墜脹持續(xù)時間方面均有改善,且治療組優(yōu)于對照組,差異有統(tǒng)計學意義(t=2.327,P0.05;t=2.388,P0.05;t=4.33,P0.05;t=4.723,P0.05)。(3)熏洗治療后第7天,兩組患者肛門疼痛程度、肛門疼痛持續(xù)時間、肛門墜脹程度、肛門墜脹持續(xù)時間與熏洗治療前相比均有明顯改善,差異有統(tǒng)計學意義(所有P0.05);兩組患者在這些方面相比較,治療組明顯優(yōu)于對照組,差異有統(tǒng)計學意義(t=2.988,P0.05;t=3.576,P0.05;t=2.632,P0.05;t=4.985,P0.05)。(4)兩組患者肛門疼痛、墜脹的消除時間相比較,治療組均明顯短于對照組,差異有統(tǒng)計學意義(t=2.688,P0.05;t=2.683,P0.05);同時治療組在肛門疼痛、墜脹方面的臨床療效高于對照組,差異有統(tǒng)計學意義(Z=2.784,P0.05;Z=2.566,P0.05)。(5)本研究兩組共80例患者,治療前及治療7天后的血常規(guī)、肝腎功均未見明顯異常,治療期間均未發(fā)生與熏洗治療相關(guān)的嚴重不良反應(yīng)。結(jié)論:腫痛熏洗液和0.02%高錳酸鉀熏洗均能有效治療RPH聯(lián)合外痔切除術(shù)后的肛門疼痛、墜脹,且安全無副反應(yīng),但兩種藥物比較而言,腫痛熏洗液的臨床療效優(yōu)于0.02%高錳酸鉀。
[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.
【學位授予單位】：西南醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R657.18

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