电脑治疗仪与传统手术治疗轻中度痔疗效比较

发布时间:2007-07-09    浏览次数:6288

摘要 对轻、中度痔应用电脑治疗仪与传统手术治疗效果进行对比分析,期望为痔手术方案的选择提供依据。将需手术治疗的轻中度痔患者 100 例,随机分为两组各 50 例,分别应用电脑治疗仪与传统手术治疗。观察术后疼痛、排尿、出血情况,基本恢复一般正常工作时间及随访 1 年的疗效。两组手术时间、术后疼痛、排尿情况均无显著差别。术后无大出血。两组病例随访 1 年,无肛门狭窄、肛门功能障碍。结果表明,对轻、中度痔的手术治疗,两组手术方法都具有安全、有效、简便、省时的特点,但电脑综合治疗仪能缩短治疗时间。

关键词 痔;电脑治疗仪;手术

Comparison of the Therapeutic Efficacy of Computerized Inserument Therapy

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Vs Traditional Surgical Therapy for Mild and Moderate Hemorrhoids

Zhu Gang , Tan Jingfan , Lin Mei

The Coloproctological Hospital of Beijing Municipality ,Beijing 100032

Abstract The therapeutic efficacy of compyterized instrument therapy and traditional surgical therapy for mild and moderate hemorrhoids was compared in an attempt of providing basis for therapeutic choice . One hundred patients with mild or moderate hemorrhoids were divided randomly into two groups , 50 for each group ,receiving computerized instrument therapy and traditional surgical therapy respectively . The aspects of postoperative pain , frequency of urination , bleeding , recovery status and findings of one-year follow up in the two groups were compared . As results , there were no differences in operation duration , postoperative pain and urination between the two groups . There was no postoperative hematorrhea and no anal stricture or anal malfunction in both groups follow-up one year . It is concluded that these two therapies are all safe , is better in terms of shortering treatment duration of time .

Key words Hemorrhoid ; Computerized instrument ; Surgical operation

应用电脑治疗仪治疗痔 50 例,并与传统手术治疗的 50 例进行疗效对比观察,现将结果报告如下。

•  资料与方法

1.1 临床资料 需手术治疗的轻、中度痔患者 100 例,发病部门占肛门 1/2 周径以内。随机分为两组各 50 例,分别应用电脑治疗仪(电脑组)与传统手术(传统组)治疗。电脑组 50 例,男 24 例,女 26 例;年龄( 45 ± 12 )岁( 21~73 岁)。

1.2 治疗方法 术前清洁灌肠,肛周局部麻醉。电脑组:以电脑综合治疗仪切除痔核。传统组:以外剥内扎和结扎注射方法处理痔核。术后均正常饮食,给予抗炎、输液、换药、对症等治疗。

1.3 观察指标 手术时间、术后疼痛、排尿、出血、基本恢复一般正常工作时间,随访 1 年的疗效。疼痛程度评估采用主诉疼痛分级( visual analogue scale , VAS )及数字评分法( numeric rating scale , NRS ) [1] 将疼痛程度分为无痛、轻、中、重及极度疼痛。

2 结果

2.1 手术时间 电脑组:( 10 ± 3 ) min ( 6~12min ) , 传统组:( 11 ± 4 ) min(6~24min)(p > 0.05) 。

2.2 疼痛出现时间及强度 电脑组:手术后麻醉药逐渐失效平均约( 27 ± 8 ) min(0~51min) ,患者感动肛门疼痛。无痛、轻度疼痛 37 例( 74% ),中度疼痛 12 例( 24% ),重度疼痛 1 例( 2% )。传统组:手术后麻醉药逐渐失效平均( 25 ± 9 ) min ( 0~52min ),患者感到肛门疼痛。无痛、轻度疼痛 36 例( 72% ),中度疼痛 13 例( 26% ),重度疼痛 1 例( 2% )。两组无统计学意义。

2.3 排尿情况 术后部分患者因肛门括约肌痉挛疼痛出现排尿困难,但无导尿病例。平均导尿时间电脑组为( 135 ± 36 ) mi n ( 35 ~ 360min ),传统组为( 121 ± 33 ) min(25 ~330min) 。两组无统计学意义。

2.4 出血情况 两组病例术中及术后均未发生大出血。

2.5 恢复工作时间 电脑组:( 10 ± 4 ) d ( 2~15d );传统组:( 18 ± 3 ) d ( 8~20 ) d 。两组有统计学意义( p < 0.01 )。无术后感染者。

2.6 随访 两组病例术后随访 1 年均无肛门狭窄、肛门功能障碍。两组术后 3~11 个月,均有 3 例手术再次治疗,占 6% 。

3 讨论

对轻、中度痔应用电脑治疗仪与传统手术治疗效果进行对比分析,期望为痔手术治疗方案的选择提供依据。结果显示,对需手术治疗的轻、中度痔,两种方法都具有安全、有效、简便、省时的特点。手术时间仅需 10 余分钟,术后 70% 为轻度疼痛,排尿情况良好, 2~3h 内自主排尿,无需导尿。术中、术后无大出血,术后无创口感染。电脑综合治疗仪直接封闭血管,切除痔核,恢复时间缩短。两组病例随访 1 年,无肛门狭窄和肛门功能障碍。

参考文献:

1 刘俊杰,赵俊 .现代麻醉学.第 2 版.北京:人民卫生出版社, 1996 . 1427 , 1444 .

文件来源于《中国肛肠病杂志》 2007 年第 27 卷第 1 期 P38