CAJ | 학술논문

目的：探讨提肛运动对痔吻合器痔上黏膜环切术(PPH)术后患者肛门坠胀的改善效果。方法收集并筛选2013年4月~2014年6月在重庆市大足区人民医院确诊为混合痔的患者140例，将其按照随机数字表方法分为两组，观察组和对照组每组各70例，两组患者入院后第2天起给予PPH术治疗，所有操作均规范，并严格参考手术适应证，排除不适宜手术的干扰因素。其中对照组给予术后常规抗感染治疗及护理。观察组患者在上述常规干预的基础上于术后第3天给予提肛运动记录患者术后肛门坠胀消失时间，同时观察比较两组术后肛门坠胀持续时间、程度、控便能力、便感急等量化评分。结果两组患者术后肛门坠胀持续时间、坠胀发生程度的评分均较干预前降低，差异均有统计学意义[观察组：(2.17±0.23)比(0.05±0.00)分，(2.16±0.11)比(0.05±0.01)分；对照组：(2.19±0.07)比(1.07±0.12)分，(2.21±0.14)比(0.65±0.01)分，均 P<0.05]，术后观察组的评分改善较对照组更为显著，差异有统计学意义(均P<0.05)。观察组术后肛门坠胀消失时间、控便能力评分及便感急评分均较对照组下降，差异均有统计学意义[(3.50±1.14)比(5.55±1.01)分，(0.10±0.00)比(0.46±0.11)分，(0.14±0.01)比(0.37±0.02)分，均P<0.05]。结论适宜的提肛运动可明显改善PPH术后肛门坠胀，减轻患者肛门坠胀程度，减少肛门坠胀时间，显著减轻PPH术后带给患者的不适感。
목적：탐토제항운동대치문합기치상점막배절술(PPH)술후환자항문추창적개선효과。방법수집병사선2013년4월~2014년6월재중경시대족구인민의원학진위혼합치적환자140례，장기안조수궤수자표방법분위량조，관찰조화대조조매조각70례，량조환자입원후제2천기급여PPH술치료，소유조작균규범，병엄격삼고수술괄응증，배제불괄의수술적간우인소。기중대조조급여술후상규항감염치료급호리。관찰조환자재상술상규간예적기출상우술후제3천급여제항운동기록환자술후항문추창소실시간，동시관찰비교량조술후항문추창지속시간、정도、공편능력、편감급등양화평분。결과량조환자술후항문추창지속시간、추창발생정도적평분균교간예전강저，차이균유통계학의의[관찰조：(2.17±0.23)비(0.05±0.00)분，(2.16±0.11)비(0.05±0.01)분；대조조：(2.19±0.07)비(1.07±0.12)분，(2.21±0.14)비(0.65±0.01)분，균 P<0.05]，술후관찰조적평분개선교대조조경위현저，차이유통계학의의(균P<0.05)。관찰조술후항문추창소실시간、공편능력평분급편감급평분균교대조조하강，차이균유통계학의의[(3.50±1.14)비(5.55±1.01)분，(0.10±0.00)비(0.46±0.11)분，(0.14±0.01)비(0.37±0.02)분，균P<0.05]。결론괄의적제항운동가명현개선PPH술후항문추창，감경환자항문추창정도，감소항문추창시간，현저감경PPH술후대급환자적불괄감。
Objective To study the improved effect of anus movement on anus bulge after procedure for prolapse and hemorrhoids (PPH). Methods 140 cases of patients with mixed hemorrhoid in Dazu District People's Hospital from April 2013 to June 2013 were collected, and they were divided into observation group and control group according to random number table method, 70 cases in each group. Patients of the two groups were given PPH surgery treatment in the second day after admission, followed all operating norms, and referenced surgical indication strictly, the interference factors of unfit for surgery were eliminated. The control group was given routine anti-infection treatment and postopera-tive care. Patients of the observation group was given the treatment on the basis of the conventional intervention at the 3rd day postoperative was carried anus movement. The patients' postoperative anus bulge disappear time were recorded, postoperative anus bulge duration, the degree of the anus bulge, and control ability, fecal urgency of two groups were observed, and quantitative evaluation was given at the same time. Results The scores of postoperative anus bulge dura-tion, the degree of the anus bulge in the observation group and control group were lower compared with before, the dif-ferences were statistically significant [observation group: (2.17±0.23) v s (0.05±0.00) scores, (2.16±0.11) v s (0.05±0.01) scores; control group: (2.19±0.07) vs (1.07±0.12) scores, (2.21±0.14) vs (0.65±0.01) scores, all P< 0.05], and the ob-servation group were improved more significantly postoperative than the control group, the differences was statistically significant (P<0.05). The postoperative anus bulge disappear time , the scores of control ability and fecal urgency in observation group were decreased than those in the control group, the differences had statistical significances [(3.50±1.14) vs (5.55±1.01) scores, (0.10±0.00) vs (0.46±0.11) scores, (0.14±0.01) vs (0.37±0.02) scores, all P< 0.05]. Con-clusion The appropriate rectal carcinoma intervention is more obvious in patients with postoperative anus belly after PPH, and can effectively reduce the anus bulge, shorten the time of the anus bulge, reduce the discomfort caused by PPH.