發(fā)布時間：2018-07-28 21:41

【摘要】：目的：通過觀察混合痔患者接受外剝內(nèi)扎術(shù)后,在術(shù)后恢復(fù)期間,使用痔洗散熏蒸與坐浴兩種治療方式的組合方案,以對各種組合方案的療效對比結(jié)果,探求熏蒸與坐浴的優(yōu)劣,并獲得最佳治療組合,提高手術(shù)效果。方法：將符合病例納入標準的,經(jīng)過篩選的患者共計80例,隨機分成4組,為觀察A、B、C、D組,觀察A組自術(shù)后第一天開始每天取痔洗散30g浸熱水1500ml,先對肛門切口熏蒸10-15分鐘,待水溫合適后將整個肛門浸入藥液坐浴20-30分鐘。觀察B組坐浴不熏蒸,觀察C組只熏蒸不坐浴,觀察D組不熏蒸也不坐浴。分別統(tǒng)計手術(shù)后3天、6天、9天的肛門切口疼痛程度、肛門切口水腫程度、肛門切口肉芽生長情況、肛門切口創(chuàng)面分泌物量,其中肛門切口疼痛程度、肛門切口水腫程度、還需要統(tǒng)計術(shù)后第1天情況,還有患者出院時的主觀感受評分、患者住院天數(shù)、患者手術(shù)切口完全愈合的天數(shù)等指標。結(jié)果：術(shù)后第3天和術(shù)后第6天,觀察A組在肛門切口疼痛程度、肛門切口水腫程度、肛門切口創(chuàng)面分泌物量等指標上均明顯均優(yōu)于其他三組,有明顯新差異(P0.05)；在肛門切口肉芽生長情況上,僅在術(shù)后第3天時優(yōu)于其他三組,有明顯新差異(P0.05)；觀察B組和觀察C組在術(shù)后第3天、術(shù)后第6天中,在肛門切口疼痛程度指標上均明顯均優(yōu)于觀察D組,有明顯新差異(P0.05)；觀察B、C兩組僅在術(shù)后第3天,在肛門切口創(chuàng)面分泌物量明顯優(yōu)于觀察D組；而在肛門切口水腫程度方面,觀察C組明顯優(yōu)于觀察B組(P0.05)；其中A、B、C三組均能在手術(shù)切口愈合時間中顯著優(yōu)于D組(P0.05),且觀察A組在其中更優(yōu)于其他三組(P0.05)；患者出院時的主觀感受方面,僅觀察A組顯著優(yōu)于D組(P0.05)；但四組患者在出院天數(shù)上無明顯差異(P0.05)。結(jié)論：痔洗散在混合痔外剝內(nèi)扎硬注射術(shù)后恢復(fù)期間,將熏蒸和坐浴聯(lián)合運用的臨床效果最佳,各項指標均優(yōu)于其他三組,有能效提高手術(shù)療效,減少術(shù)后并發(fā)癥,減輕患者痛苦,提高患者對手術(shù)的評價,且在術(shù)后越早使用效果越好,相關(guān)治療方法和藥物值得在肛腸科中推廣。
[Abstract]:Objective: to observe the combination of hemorrhoids fumigation and sitting bath in patients with mixed hemorrhoids after external exfoliation and internal ligation. To explore the advantages and disadvantages of fumigation and sitting bath, and to obtain the best treatment combination to improve the effect of surgery. Methods: a total of 80 patients who met the criteria were randomly divided into 4 groups. Group A took 30 g of hemorrhoid powder to soak hot water daily from the first day after operation, and fumigated the anal incision for 10-15 minutes. Immerse the whole anus in the bath for 20-30 minutes after the water temperature is suitable. No fumigation in group B, no fumigation in group C, and no fumigation and no sitting bath in group D. The degree of anal incision pain, the degree of anal incision edema, the growth of granulation of anal incision, the amount of secretion of anal incision wound, the degree of anal incision pain and the degree of anal incision edema were counted. It is also necessary to count the first day after operation, the subjective feeling score of the patient when discharged from hospital, the days of hospitalization, the days of complete healing of the surgical incision, and so on. Results: on the 3rd and 6th day after operation, the degree of pain, edema and secretion of anal incision in group A were significantly better than those in other three groups (P0.05). On the third day after operation, the growth of granulation in anal incision was better than that in the other three groups (P0.05), while the growth of granulation in group B and C was observed on the third day after operation, and on the sixth day after operation. The indexes of pain degree of anal incision were significantly better than that of group D (P0.05), the volume of secretion in group B C was significantly better than that in group D on the third day after operation, but the degree of edema in anal incision was higher than that in group D. Group C was significantly better than group B (P0.05), and group C was significantly better than group D in the healing time of surgical incision (P0.05), and group A was better than other three groups (P0.05). Only group A was significantly better than group D (P0.05), but the four groups had no significant difference in discharge days (P0.05). Conclusion: the combined use of fumigation and sitting bath is the best clinical effect during the recovery of mixed hemorrhoids after external peeling and internal ligation and hard injection, and all the indexes are superior to the other three groups. It can improve the efficiency of the operation and reduce the postoperative complications. In order to alleviate the pain of patients and improve the evaluation of surgery, the earlier the operation is used, the better the effect is. The related treatment methods and drugs are worth popularizing in anorectal department.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R266

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