本文選題：痔瘡　切入點(diǎn)：術(shù)后并發(fā)癥　出處：《西南醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討肛門腫痛熏洗液在痔術(shù)后并發(fā)癥患者治療中的安全性和有效性,為促進(jìn)中醫(yī)藥的現(xiàn)代化發(fā)展和更好的指導(dǎo)臨床,為痔術(shù)后并發(fā)癥的治療提供一定的理論基礎(chǔ)。方法:選取我院肛腸科住院部2014年6月-2015年6月符合納入標(biāo)準(zhǔn)、排除標(biāo)準(zhǔn),且病歷資料完整的行混合痔外剝內(nèi)扎手術(shù)治療的患者60例,依據(jù)隨機(jī)平均分組原則分為兩組,治療組30例患者于常規(guī)術(shù)后治療的基礎(chǔ)上用肛門腫痛熏洗液行肛部熏洗治療(20min/次,1次/日,連續(xù)治療7天),對照組30例患者于常規(guī)術(shù)后治療的基礎(chǔ)上用高錳酸鉀溶液(1∶5000)行肛部熏洗治療(20min/次,1次/日,連續(xù)治療7天),入組患者于熏洗治療前后行三大常規(guī)(血、大便、尿)及肝、腎功能檢查各一次,記錄患者的創(chuàng)面完全愈合時(shí)間、水腫消退時(shí)間、不良反應(yīng)發(fā)生情況,依據(jù)《中藥新藥臨床研究指導(dǎo)原則(2002版)》評定入組患者熏洗治療前及熏洗治療后第4、7天肛門出血、墜脹、疼痛、水腫等并發(fā)癥情況,采用SPSS20.0軟件包對收集的數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,計(jì)數(shù)資料用百分率(%)表示,兩組間比較采用卡方檢驗(yàn);計(jì)量資料用(均數(shù)±標(biāo)準(zhǔn)差)表示,組間比較采用t檢驗(yàn),組內(nèi)治療前后用配對t檢驗(yàn);等級資料采用Mann-Whitney U檢驗(yàn),P0.05時(shí),則表示有統(tǒng)計(jì)學(xué)差異性。結(jié)果:(1)兩組患者熏洗治療前術(shù)后疼痛、出血、墜脹、水腫的總體評分接近(t=2.034,P0.05);熏洗治療后,治療組和對照組患者術(shù)后并發(fā)癥總體評分均得到減輕(t=12.659,P0.05;t=10.554,P0.05),且治療組優(yōu)于對照組(t=8.354,P0.05)。(2)治療組患者水腫平均消退時(shí)間、創(chuàng)面完全愈合時(shí)間均優(yōu)于對照組(t=6.214,P0.05;t=7.554,P0.05)。(3)兩組患者熏洗治療前術(shù)后出血積分相當(dāng)(t=2.089,P0.05);兩組患者行熏洗治療后術(shù)后出血均有所改善,且治療組患者熏洗治療后第4、7天術(shù)后出血積分小于對照組(t=8.895,P0.05;t=7.216,P0.05)。(4)兩組患者熏洗治療前術(shù)后墜脹積分相近(t=1.054,P0.05);兩組患者行熏洗治療后術(shù)后墜脹均有所改善,治療組患者熏洗治療后第4、7天術(shù)后墜脹積分小于對照組,但差異無統(tǒng)計(jì)學(xué)意義(t=1.651,P0.05;t=1.842,P0.05)。(5)兩組患者熏洗治療前術(shù)后疼痛積分相當(dāng)(t=1.247,P0.05);兩組患者行熏洗治療后術(shù)后疼痛均有所改善,且治療組患者熏洗治療后第4、7天術(shù)后疼痛積分小于對照組(t=4.557,P0.05;t=4.389,P0.05)。(6)本研究入組60例患者,治療前后三大常規(guī)(大便、血、尿)及肝、腎功能檢查均正常,治療期間未發(fā)生與熏洗治療相關(guān)的顯著異常。結(jié)論:肛門腫痛熏洗液可有效促進(jìn)痔瘡術(shù)后常見并發(fā)癥的恢復(fù),可考慮推廣運(yùn)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 鹵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.
【學(xué)位授予單位】：西南醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R266

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