摘要
目的探讨混合痔患者外剥内扎术(MMH)术后肛缘水肿发生的危险因素。方法回顾性分析2017年1月至2020年1月于温岭市第一人民医院行MMH治疗的混合痔患者600例的临床资料,根据术后肛缘水肿发生情况分为研究组(术后发生肛缘水肿,n=272)和对照组(术后未发生肛缘水肿,n=328)。比较两组患者性别、年龄、缝合手术切口、松解肛门内括约肌、伴有感染、术中操作、术后排便情况、术后中药熏洗情况,并进行单因素分析、logistic回归分析MMH术后肛缘水肿发生的危险因素。结果两组患者缝合手术切口[20.22%(55/272)比18.29%(60/328)]、伴有感染[15.44%(42/272)比17.68%(39/328)]、松解肛门内括约肌[15.81%(43/272)比17.68%(58/328)]、术后中药熏洗[72.79%(198/272)比71.65%(235/328)]差异均无统计学意义(χ^(2)=0.35、1.60、0.37、0.09,均P>0.05)。经过多因素logistic回归分析显示,女性、年龄≤60岁、术后操作不合理、术后排便异常均是影响MMH术后发生肛缘水肿的独立危险因素(OR=2.28、2.52、5.95、3.07,均P<0.05)。结论患者性别、年龄、手术操作以及术后排便均是MMH术后发生肛缘水肿的危险因素,临床上需要对此进行合理的围手术期干预,尽量避免术后肛缘水肿发生。
Objective To investigate the risk factors of anal margin edema after Milligan-Morgan hemorrhoidectomy(MMH)in patients with mixed hemorrhoids.Methods The clinical data of 600 patients with mixed hemorrhoids undergoing MMH in the First People's Hospital of Wenling from January 2017 to January 2020 were retrospectively analyzed.The patients were divided into study(with anal margin edema,n=272)and control(without anal margin edema,n=328)groups according to whether anal margin edema occurred after surgery.Gender,age,surgical incision suture,internal anal sphincter relaxation,infection,intraoperative operation,postoperative defecation,and postoperative fumigation with traditional Chinese medicine were compared.The risk factors of anal margin edema after MMH were analyzed by univariate analysis and logistic regression analysis.Results There were no significant differences in suture of surgical incision[20.22%(55/272)vs.18.29%(60/328)],infection[15.44%(42/272)vs.17.68%(39/328)],internal anal sphincter relaxation[15.81%(43/272)vs.17.68%(58/328)],and postoperative fumigation with traditional Chinese medicine[72.79%(198/272)vs.71.65%(235/328)]between the two groups(χ^(2)=0.35,1.60,0.37,0.09,all P>0.05).Multivariate logistic regression analysis showed that female gender,age≤60 years,unreasonable postoperative operation,and abnormal defecation were all independent risk factors for anal margin edema after MMH(OR=2.28,2.52,5.95,3.07,all P<0.05).Conclusion Gender,age,surgical operation,and postoperative defecation are the risk factors for anal margin edema after MMH.Clinically,it is necessary to carry out reasonable perioperative intervention to avoid the occurrence of postoperative anal margin edema.
作者
叶玮
李霞
Ye Wei;Li Xia(Department of Anorectal Surgery,the First People's Hospital of Wenling,Wenling 317500,Zhejiang Province,China)
出处
《中国基层医药》
CAS
2022年第10期1540-1543,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
痔
外科手术
肛管
水肿
危险因素
Hemorrhoids
Surgical procedures,operative
Anal canal
Edema
Risk factors
