摘要
目的观察健脾益气法联合弹力线内套外剥术治疗老年脱垂型混合痔的临床疗效。方法将120例老年脱垂型混合痔患者随机分为联合治疗组、无中药弹力线组及外剥内扎组,每组各40例。分别使用健脾益气法联合弹力线内套外剥术、单纯弹力线内套外剥术及传统外剥内扎术进行治疗。观察手术时长、术中出血量、住院时长、创面完全愈合时间,并于手术当天及术后第3、7、14天观察3组患者手术切口疼痛、肛缘水肿、排便困难情况并记录症状积分进行比较。结果联合治疗组与无中药弹力线组患者手术时长、术中出血量、住院时长、创面完全愈合时间均低于外剥内扎组,差异均有统计学意义(P<0.05);其中联合治疗组相较无中药弹力线组创面完全愈合时间更短,差异有统计学意义(P<0.05)。术后第3、第7天联合治疗组疼痛、水肿、排便困难积分均低于无中药弹力线组及外剥内扎组,差异均有统计学意义(P<0.05)。结论使用弹力线内套外剥术治疗老年脱垂型混合痔能显著减少术中出血、缩短痊愈时间,减轻术后疼痛及水肿,联合围术期健脾益气法干预能进一步减轻术后并发症、促进创面愈合,值得推广。
Objective To study the clinical effect of invigorating spleen and replenishing Qi combined with internal elastic line ringing and external dissection on treating elderly prolapsed mixed hemorrhoids. Methods 120 elderly patients with prolapsed mixed hemorrhoids were randomly divided into combined treatment group,non-Chinese medicine elastic line group,and external dissection and internal ligation group,with 40 patients in each group. The three groups were treated with invigorating spleen and replenishing Qi combined with internal elastic line ringing and external dissection,internal elastic line ringing and external dissection,and traditional external dissection and internal ligation. To observe the length of operation,the amount of bleeding during the operation,the length of hospital stay,and the time to complete wound healing. The pain of surgical incision,anal edema,and difficulty in defecation were observed in three groups of patients on the day of surgery and on the 3 rd,7 th,and 14 th days after surgery,and the symptom score was recorded for comparison. Results The length of operation,the amount of bleeding during the operation,the length of hospital stay,and the time to complete wound healing in the combined treatment group and the non-Chinese medicine elastic line group were all lower than those in the external dissection and internal ligation group,and the differences were statistically significant(P<0.05);The healing time of the combined treatment group was shorter than that of the non-Chinese medicine elastic line group,and the difference was statistically significant(P<0.05). The scores of pain,edema,and difficulty in defecation in the combined treatment group on the 3 rd and 7 th days after operation were all lower than those in the non-Chinese medicine elastic line group and the external dissection and internal ligation group,and the differences were statistically significant(P<0.05). Conclusion The treatment of elderly prolapsed mixed hemorrhoids with elastic line inner sleeve and outer stripping can significantly reduce intraoperative bleeding,shorten healing time,reduce postoperative pain and edema,combined with invigorating spleen and replenishing Qi can further reduce postoperative complications and promote wound healing,which is worth promoting.
作者
彭云花
杨巍
陈天
王清园
马燕玲
PENG Yunhua;YANG Wei;CHEN Tian;WANG Qingyuan;MA Yanling(Shuguang Hospital Afiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)
出处
《辽宁中医药大学学报》
CAS
2020年第12期82-85,共4页
Journal of Liaoning University of Traditional Chinese Medicine
基金
国家自然科学基金项目(81673768)
上海市临床重点专科项目(shslczdzk04302)
上海市卫计委资助项目(SHGZS-2017028)。
关键词
健脾益气法
弹力线内套外剥
混合痔
老年
术后并发症
invigorating spleen and replenishing Qi method
internal elastic line ringing and external dissection
mixed hemorrhoids
the elderly
postoperative complications
作者简介
彭云花(1986-),女,上海人,主治医师,博士研究生,研究方向:肛肠良性疾病的中西医治疗;通讯作者:马燕玲(1964-),女,上海人,副主任医师,学士,研究方向:肛肠良性疾病的中西医治疗。
