肠道微生态制剂对痔吻合器术后并发症的影响

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摘要目的探讨肠道微生态制剂对痔吻合器术后并发症的影响。方法选取2017年6月～2018年6月中国中医科学院广安门医院肛肠科行痔上黏膜环切术（PPH）的患者70例。采用随机数字表法将患者分为观察组（n = 35）与对照组（n = 35）。对照组常规术前准备，观察组在对照组基础上予口服及保留灌肠双歧杆菌三联活菌及枯草二联活菌制剂。采用视觉模拟评分（VAS）比较两组患者术后疼痛程度；比较两组出血、肛门坠胀缓解时间、吻合口炎症程度。结果术后第1天，两组VAS评分比较，差异无统计学意义（P ＞ 0.05）。术后第7天，观察组VAS评分低于对照组，差异有统计学意义（P ＜ 0.05）。观察组术后出血肛门坠胀发生率与对照组比较，差异无统计学意义（P ＞ 0.05）；观察组患者平均肛门坠胀缓解时间短于对照组，差异有统计学意义（P ＜ 0.05）。术后第7天及1个月，观察组吻合情况优于对照组，差异有统计学意义（P ＜ 0.05）。术后1个月内两组均未出现吻合口瘘。结论术前微生态制剂的应用有可能减轻PPH术后疼痛，使肛门坠胀缓解较快，降低吻合口炎症发生概率。

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	李峨1 徐佳2 何颖华1

关键词 ：肠道菌群, 痔上黏膜吻合器手术, 吻合口炎症, 术后并发症

Abstract：Objective To investigate the effect of intestinal microecological preparation on complications after hemorrhoid stapler operation. Methods Seventy patients underwent procedure for prolapse hemorrhoids (PPH) in the Anorectal Department of Guanganmen Hospital, China Academy of Chinese Medical Sciences from June 2017 to June 2018 were selected, patients were divided into observation group (n = 35) and control group (n = 35) by random number table method. Routine preoperative preparation was performed in the control group, and the observation group were given oral and retention enema of Bifidobacterium Triad and Subtilis Triad on the basis of the control group. Visual analogue scale (VAS) was used to compare the postoperative pain degree of the two groups, as well as the relief time of bleeding, anal distension and anastomotic inflammation degree of the two groups. Results VAS scores of the two groups on the first day after surgery showed no statistically significant difference (P ＞ 0.05). VAS score of observation group was lower than that of control group on the 7th day after the operation, and the difference was statistically significant (P ＜ 0.05). The incidence of postoperative bleeding and anal distension in the observation group was compared with that in the control group, and the difference was not statistically significant (P ＞ 0.05). Patients in the observation group had shorter time to relieve anal distention than those in the control group, and the difference was statistically significant (P ＜ 0.05). On the 7th day after the operation, the incidence of mild anastomotic inflammation was lower in the observation group than in the control group, with statistically significant difference (P ＜ 0.05). The anastomosis condition of observation group was better than that of control group on the 7th day and the 1st month after the operation, and the differences were statistically significant (P ＜ 0.05). No anastomotic leakage occurred in both groups within 1 month after operation. Conclusion The application of preoperative microecological preparation may reduce the postoperative pain of PPH, relieve the anal distension quickly, and decrease the incidence of anastomotic inflammation.

Key words： Intestinal microflora Hemorrhoid stapler operation Anastomotic inflammation Postoperative complications

引用本文:

李峨1 徐佳2 何颖华1. 肠道微生态制剂对痔吻合器术后并发症的影响[J]. 中国医药导报, 2019, 16(22): 90-93.
LI E1 XU Jia2 HE Yinghua1. Effect of intestinal microecological preparation on complications after hemorrhoid stapler operation. 中国医药导报, 2019, 16(22): 90-93.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2019/V16/I22/90

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