摘要
目的:探讨单纯四点牵引法和荷包缝合牵引法对吻合器痔上黏膜环切术(PPH)治疗重度痔病的临床效果。方法:选取2018年3月至2019年5月期间我院收治的重度痔病患者60例,按照简单随机化将患者分为研究组和对照组各30例,研究组采取单纯四点牵引法,对照组采取荷包缝合牵引法。采用视觉模拟评分(VAS)评估患者的疼痛程度,采用排便失禁程度评分量表(FISI)、排便梗阻症状(ODS)评分估患者的排便失禁、梗阻程度,比较两组的VAS评分、手术相关指标、FISI评分、ODS评分、临床疗效、术后并发症发生情况。结果:研究组的VAS评分与对照组比较明显较低,研究组的术中出血量与对照组比较明显较高,差异有统计学意义(P<0.05);两组的手术时间、术后住院时间比较,差异无统计学意义(P>0.05)。两组手术后的FISI评分、ODS评分与手术前比较明显降低,差异有统计学意义(P<0.05);手术后研究组患者的FISI评分、ODS评分与对照组比较明显较低,差异有统计学意义(P<0.05)。研究组的治疗总有效率96.7%,与对照组的90.0%比较较高,但差异无统计学意义(P>0.05)。研究组的术后并发症发生率为6.7%,与对照组的20.0%比较较低,但差异无统计学意义(P>0.05)。结论:PPH治疗重度痔病采用单纯四点牵引法较荷包缝合牵引法更能有效减轻患者疼痛、排便失禁、梗阻程度,减少患者术后并发症的发生,值得推广。
Objective:To explore the clinical effect of simple four-point traction method and purse-string suture traction method on the treatment of severe rickets with anastomotic sacral hemorrhoidectomy(PPH).Methods:60 patients with severe rickets admitted to our hospital from March 2018 to May 2019 were enrolled.The patients were divided into study group and control group according to the simple randomization.The study group adopted a simple four-point traction method.The control group was subjected to a purse-string suture traction method.Visual analog scale(VAS)was used to assess the degree of pain in patients.Defecation incontinence scale(FISI)and defecation obstruction(ODS)scores were used to estimate the degree of defecation incontinence and obstruction.The VAS scores and surgical related indexes were compared between the two groups.FISI score,ODS score,clinical efficacy,postoperative complications.Results:The VAS score of the study group was significantly lower than that of the control group.The intraoperative blood loss of the study group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).The operation time and postoperative hospital stay of the two groups were statistically significant(P<0.05).The difference was not statistically significant(P>0.05).The FISI score and ODS score of the two groups were significantly lower than those before operation(P<0.05).The FISI score and ODS score of the study group were significantly lower than those of the control group.The total effective rate of the study group was 96.7%,which was higher than that of the control group,but the difference was not statistically significant(P>0.05).The postoperative complication rate of the study group was 6.7%,which was lower than that of the control group(20.0%),but the difference was not statistically significant(P>0.05).Conclusion:PPH treatment of severe rickets using simple four-point traction method is more effective than the purse-string suture traction method in reducing pain,defecation incontinence,obstruction,and reducing postoperative complications.It is worth promoting.
作者
李国利
张素云
LI Guoli;ZHANG Suyun(The Hospital of Chifeng, Neimenggu Chifeng 024000, China)
出处
《河北医学》
CAS
2020年第4期686-689,共4页
Hebei Medicine
基金
内蒙古科技计划项目,(编号:2017BBG70141)
内蒙古赤峰市医院科研项目(编号:2014-KY013)。
