摘要
目的探讨围术期管理在吻合器痔上黏膜环切术(PPH)治疗老年痔疮患者中的应用效果。方法选取2018年2月至2019年1月在嘉兴学院附属第二医院行PPH治疗的128例老年患者,按随机数字表法分为常规组(64例)和干预组(64例),常规组采取常规医护管理,干预组在此基础上采取围术期干预,比较两组患者的治疗效果。结果干预组患者便秘次数、便血次数和住院时间均明显少于常规组[(0.8±0.6)次/d比(1.2±0.4)次/d,(1.3±0.8)次/d比(2.0±1.0)次/d,(4.9±1.1)d比(7.4±1.3)d,t=4.438、4.372、11.744,均P=0.000];干预组干预管理前疼痛(VAS)评分和抑郁量表(GDS)评分与常规组比较差异均无统计学意义[(5.0±1.6)分比(5.2±1.3)分,(22.2±2.9)分比(22.5±2.6)分,t=0.776、0.616,P=0.220、0.269],干预组患者干预后与常规组患者疼痛VAS评分和GDS评分比较差异有统计学意义[(2.7±0.7)分比(3.2±1.1)分,(17.2±1.8)分比(19.0±2.2)分,t=3.068、5.066,P=0.001、0.000];干预组患者生理机能、情感职能、社会功能、精神健康和健康状况等生活质量评分均明显高于常规组(均P<0.05)。结论围术期干预管理在PPH治疗老年痔疮患者中效果良好,不仅能有效改善临床症状和减少治疗时间,同时能减轻疼痛和提高预后生活质量。
Objective To investigate the efficacy of perioperative management in elderly hemorrhoids patients undergoing procedure for prolapse and hemorrhoids(PPH). Methods A total of 128 elderly patients treated with PPH in the Second Affiliated Hospital of Jiaxing University from February 2018 to January 2019 were enrolled and randomly divided into the routine group(n=64)and the intervention group(n=64). The routine group underwent routine postoperative management, and the intervention group received intervention postoperative management as add-on to routine postoperative management.Clinical efficacy was compared between the two groups. Results The frequency of constipation and hematochezia was less and the hospitalization days were shorter in the intervention group than in the routine group(0.8±0.6 times/d vs.1.2±0.4 times/d, 1.3±0.8 times/d vs.2.0±1.0 times/d, 4.9±1.1 days vs.7.4±1.3 days, t=4.438, 4.372 and 11.744 respectively, all P=0.000). The scores of visual analog scale(VAS)and geriatric depression scale(GDS)had no significant difference between the intervention and routine groups(5.0±1.6 scores vs.5.2±1.3 scores for VAS;22.2±2.9 scores vs.22.5±2.6 scores for GDS, t=0.776 and 0.616, P=0.220 and 0.269)before intervention, and had significant difference between the intervention and routine groups[2.7±0.7 scores vs.3.2±1.1 scores for VAS;17.2±1.8 scores vs.19.0±2.2 scores for GDS(t=3.068 and 5.066, P=0.001 and 0.000)]after intervention.The scores of quality of life, including physiological function, emotional function, social function, mental health and health status, were higher in the intervention group than in the routine group(all P<0.05). Conclusions Intervention perioperative management is effective in elderly hemorrhoids patients undergoing procedure for prolapse and hemorrhoids.It can not only effectively improve clinical symptoms and shorten treatment time, but also alleviate pain and improve prognosis and quality of life.
作者
江能
姚玉柱
吴城
Jiang Neng;Yao Yuzhu;Wu Cheng(Department of 18 Ward,the Second Affiliated Hospital of Jiaxing University,Jiaxing 314000,China;Department of Anesthesiology,the Second Affiliated Hospital of Jiaxing University,Jiaxing 314000,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2019年第5期578-581,共4页
Chinese Journal of Geriatrics
基金
嘉兴市科技计划项目(2018AD32017).
关键词
吻合器痔上黏膜环切术
痔
Procedure for prolapse and hemorrhoids
Hemorrhoids
