CAJ | 학술논문

【目的】探讨吻合器痔上黏膜环切术（PPH）治疗精神病患者痔疮的疗效和安全性。【方法】选择本院110例合并痔疮的精神病患者，80例行PPH术治疗为观察组，30例行保守治疗作为对照组。比较两组疗效、治疗前后健康调查简表（SF‐36）、简明精神病评定量表（BPRS）得分、复发及并发症发生情况。【结果】与对照组比较，观察组有效率高于对照组，差异有统计学意义（97．5％ v s 90．0％，χ2＝4．25，P＜0．05）。两组治疗前后组内及组间的BPRS比较均无统计学意义（ P ＞0．05）。观察组和对照组治疗后SF‐36量表得分均较治疗前提高（P ＜0．05）；但两组间比较无统计学意义（P ＞0．05）。观察组术后复发率明显低于对照组，但其疼痛、出血、排尿困难、感染、大便郁结等并发症的总发生率高于对照组（ P ＜0．05）。【结论】PPH手术治疗精神病患者痔疮的效果优于保守治疗，但其并发症发生率较高，因此对精神病合并痔疮患者应首选保守治疗，次选手术治疗。
【목적】탐토문합기치상점막배절술（PPH）치료정신병환자치창적료효화안전성。【방법】선택본원110례합병치창적정신병환자，80례행PPH술치료위관찰조，30례행보수치료작위대조조。비교량조료효、치료전후건강조사간표（SF‐36）、간명정신병평정량표（BPRS）득분、복발급병발증발생정황。【결과】여대조조비교，관찰조유효솔고우대조조，차이유통계학의의（97．5％ v s 90．0％，χ2＝4．25，P＜0．05）。량조치료전후조내급조간적BPRS비교균무통계학의의（ P ＞0．05）。관찰조화대조조치료후SF‐36량표득분균교치료전제고（P ＜0．05）；단량조간비교무통계학의의（P ＞0．05）。관찰조술후복발솔명현저우대조조，단기동통、출혈、배뇨곤난、감염、대편욱결등병발증적총발생솔고우대조조（ P ＜0．05）。【결론】PPH수술치료정신병환자치창적효과우우보수치료，단기병발증발생솔교고，인차대정신병합병치창환자응수선보수치료，차선수술치료。
[Objective] To compare the feasibility and safety of surgery and conservative treatment in the treatment of patients with mental illness plus hemorrhoids .[Methods] A total of 80 surgical patients with mental illness plus hemorrhoids from January 2012 to December 2013 were randomly selected as observation group .And another 30 patients with mental illness plus hemorrhoids on conservative treatment during the same period were selected as control group .Efficacies ,short form (SF)‐36 life quality scale and brief psychiat‐ric rating scale (BPRS) scores before and after treatment ,recurrence rate and complications rate of two groups were compared .[Results]Compared with control group ,recovery rate ,significant curative rate and total cur‐ative effective rate of observation group improved while there was a lower rate of unsuccessful treatment .And the difference was statistically significant ( P < 0 .05) .For both groups ,SF‐36 points were higher at post‐treatment than those pre‐treatment ( P <0 .05) .SF‐36 and BPRS score of two groups at pre and post‐treat‐ment had no statistical significant difference ( P <0 .05) .Compared with control group ,postoperative recur‐rence rate was significantly lowered in observation group .Yet there was a higher overall incidence of pain , bleeding ,dysuria ,infection ,defecation and other complications ( P<0 .05) .[Conclusion] As compared with conservative treatment ,surgery is more efficacious for patients with mental illness plus hemorrhoids Yet there is a higher incidence of complications .Thus ,for patient withs mental illness plus hemorrhoids ,conservative treatment is preferred over surgery .