摘要:目的:观察超短波治疗对痔术后创面愈合的影响。方法:将100例混合痔术后患者分为治疗组和对照组各40例,治疗组于术后24小时给予超短波治疗和复方紫草油纱条换药,对照组仅给以复方紫草油纱条换药,观察两组创面愈合时间和创面上皮生长速度。结果:治疗组较对照组创面愈合时间更短(Plt;0.01),创面上皮生长速度更快(Plt;0.01)。结论〗:超短波治疗能够加速痔术后创面愈合时间,减少痛苦,疗效确切安全。Abstract: Objective: To observe the clinical efficacy of ultrashort wave on the healing of wound after operation for hemorrhoids. Methods: One hundred cases of disease subjected to operation were divided into the treatment group (50 cases) and the control group (50 cases).The treatment group had been given ultrashort wave 24 hours after operation and Fufangzicaoyousa ointment gauze. The control group had been give Fufangzicaoyousa ointment gauze. Results: The results showed that the woundhealing time was much shorter in the treatment group than in the control group (Plt;0.01), the epidermis growth was much faster in the treatment group than in he control group (Plt;0.01). Conclusion: Ultrashort wave can promote the healing of wound after the operation for hemorrhoids and relieve pain, and it can be externally used safely.
【摘要】目的 探讨分段整形提缩注射术治疗脱肛痔的临床疗效。方法 175例重度环状痔, 沿肛缘弧形切除结缔组织外痔以整形肛门, 再于结扎痔核基底及其上端黏膜下层注射消痔灵注射液,并进行疗效观察。结果 术后肛周水肿(72 h)、疼痛(24及72 h)明显减少； 术后4周临床治愈145例,好转23例,总有效率为96.0%； 所有患者均随访3~6个月，未见复发。结论 选择分段整形提缩注射术既比较彻底地去除了痔核使之不易复发，又整形了肛门，保护其大小和功能, 该术式可成为治疗脱肛痔的较理想术式。
ObjectiveTo observe the effect of procedure for prolapse and hemorrhoids (PPH) combined with partial internal anal sphincterotomy (Abbreviated as combined therapy) in the treatment of severe mixed hemorrhoids complicated with high rectal and anal canal resting pressure.MethodsFrom January 2016 to June 2018, the patients with grade Ⅲ–Ⅳ mixed hemorrhoids who underwent surgical treatment in this hospital were selected for the prospective study, including 100 patients with high pressure (>70 mm Hg, 1 mm Hg=0.133 kPa) and 100 patients with low pressure (≤70 mm Hg), then which were divided into an experimental group and a control group according to the random number table method (with 50 cases in each group). The patients in the control group underwent the PPH and in the experimental group underwent the combined therapy. The therapeutic effect and perioperative indicators were observed in each group, Visual Analogue Scale (VAS) was used to evaluate the degree of pain before and after the operation, the incidence of complications and the recurrence rate of symptoms were observed, the factors influencing the therapeutic effect of combined therapy were analyzed.ResultsWhether for the patients with high or low rectal and anal canal resting pressure, although the operation time of the experimental group was significantly longer than that of the control group (t=8.996, P<0.001; t=8.927, P<0.001), the total effective rate was higher (χ2=7.294, P=0.007; χ2=6.775, P=0.009), the length of stay in hospital was shorter (t=11.922, P<0.001; t=11.442, P<0.001), the hospital expenses decreased significantly (t=2.226, P=0.028; t=2.562, P=0.012), the VAS score at 24 h and 72 h after operation were lower (24 h: t=12.659, P<0.001; t=12.191, P<0.001; 72 h: t=9.920, P<0.001; t=9.901, P<0.001), the incidence of postoperative complications was lower (χ2=7.484, P=0.006; χ2=11.416, P=0.001) in the experimental group as compared with the control group; there was no significant difference between the two groups (χ2=1.042, P=0.307; χ2=0.211, P=0.646). The course of disease and the grade of internal hemorrhoids were the independent factors influencing the marked efficiency of combined therapy (χ2=7.417, P=0.009; χ2=4.286, P=0.017).ConclusionsCombined therapy is effective in treatment of severe mixed hemorrhoids complicated with high rectal and anal canal resting pressure, it could accelerate recovery of patients and relieve pain. It should be paid attention to patients with long course of disease and severe degree of internal hemorrhoids.
Objective To analyse the prevalence of hemorrhoids in 1 795 regular healthcheck adults in our hospital, and to investigate the etiologic features and preventive measures. MethodsThe anal examination data of 1 795 regular healthcheck adults werer reviewed and analysed mainly on the clinical features of hemorrhoids. Results All of these adults had long-sitting jobs and did less exercises. The prevalence of hemorrhoids was about 67.02% (1 203/1 795), of which mixed type was predominant (53.37%, 958/1 795) and constituent ratio was 79.63% (958/1 203)， Plt;0.05. The prevalence of hemorrhoids increased with age, especially in adults more than 60 years of age (gt;70%). The females under 30 years of age suffered from hemorrhoids more than the couterpart males 〔61.11% (44/72) vs. 22.50% （9/40)〕, Plt;0.05. There was no significant difference of hemorrhoids in gender whose age was above 30 years (P＞0.05). Conclusions Hemorrhoids, especially mixed types, are prevalent among the people who has a long-sitting and less sports lifestyle. More active preventive measures shall be taken in this group of people.
Objective To investigate clinical effects of modified Xiaozhiling injection with anal cushion suspensory fixation in treatment of prolapsed hemorrhoids. Methods From January 2012 to June 2013, 150 hospitalized patients with Ⅱ and Ⅲ degrees internal hemorrhoids and mixed hemorrhoid, with prolapsing as the main clinical manifestations, were included prospectively, then subsequently randomly divided into a modified Xiaozhiling injection with anal cushion suspensory fixation group (observation group), a procedure for prolapse and hemorrhoids (PPH) group, and a classic Milligan-Morgan surgery (M-M) group. The Xiaozhiling injection with saline by 1:1 mixture was injected into the rectum submucosa and perirectal gap and the anal cushion suspensory fixation were performed for the treatment of prolapsed hemorrhoids in the observation group. The operations of the PPH group and M-M group were same as the convention. The treatment effect, hospitalization time, hospital expenses, postoperative complications, and recurrence were compared among these 3 groups. Results ① Fourty-nine cases were cured and 1 case was improved in the observation group, 48 cases were cured and 2 cases were improved in the PPH group, 48 cases were cured and 2 cases were improved in the M-M group, the treatment effects had no significant differences among these 3 groups (χ2=0.411, P=0.814). ② The hospitalization time and hospitalization expenses of the observation group were significantly less than those of the PPH group (P<0.001) and the M-M group (P<0.001). ③ No prolapse of hemorrhoids and infection happened on day 1, 2, 3, 7, and 14 among these 3 groups. The pains of the observation group were slighter on day 1, 2, 3, 7, and 14 as compared with the PPH group (except on day 14,P<0.05) and the M-M group (P<0.05). The anus bulges had no significant difference between the observation group and the PPH group (except on day 1,P>0.05), which of the observation group were significantly slighter than those of the M-M group (P<0.05). The bleeding on day 2 and 3 and the perianal edema on day 3 had no significant difference between the observation group and the PPH group (P>0.05), which of the observation group were significantly slighter than those of the M-M group (P<0.05). The urinary retention had no significant difference on day 1–3 among these 3 groups (P>0.05). ④ The anal stenosis, anal continence, and hemorrhoids recurrence on month 1, 6, and 12 had no significant differences among these 3 groups (P>0.05). Conclusions Modified Xiaozhiling injection with anal cushion suspensory fixation in treatment of prolapsed hemorrhoids could effectively make anal cushion fixation, eliminate main symptoms of bleeding and prolapse, preserve anal function well. It’s clinical efficacy is same as PPH and M-M methods, with a shorter hospitalization time, less hospitalization expenses, milder postoperative complications, and lower recurrence rate.
目的探讨痔切除吻合器痔上粘膜环切术（PPH）的临床应用价值。方法采用33 mm痔切除吻合器痔上粘膜切除术对严重脱垂性痔30例进行治疗。结果全组病例平均手术时间10分钟，术后住院时间1～3天，脱出痔块均回缩，切除直肠粘膜完整率达98%，术后90%的患者无肛门疼痛，随访3个月，28例满意，2例基本满意。结论采用痔切除吻合器痔上粘膜环切术治疗严重脱垂性痔是一种新技术，其手术操作简单，具有安全、有效、手术时间短、术后疼痛轻、恢复快等特点，有望替代传统的治疗方法。
Objectives To evaluate the effect of metrinidazole treatment after conventional hemorrhoidectomy pain in patients with third and fourth degree hemorrhoids. Methods We searched the Cochrane Library (Issue 1 2009), PubMed (1966 to March 2009), EMbase (1974 to March 2009), SCI (1974 to March 2009), CBM (1978 to March 2009), CNKI (1994 to March 2009), and VIP (1989 to March 2009) to identify randomized controlled trials or quasi- randomize controlled trials of metronidazole versus placebo for treating post hemorrhoidectomy pain. We evaluated the quality of the included studies by using the Handbook 4.2.6 recommend standards and analyzed data using the Cochrane Collaboration’s RevMan 4.2.10. Results We included seven randomized controlled trials or quais-randomized controlled trials (n=553). Meta-analyses showed that there were statistical differences between metronidazole and placebo in pain after hemorrhoidectomy and the use of an additional dose of analgesia. Conclusions The current evidence shows that metronidazole relieves the pain after conventional hemorrhoidectomy and reduces the additional used of analgesics. Further high quality, large sample randomized controlled trials should be carried out.