亚甲蓝混合液联合中药痔瘘祛毒熏洗剂对混合痔外剥内扎术后患者的镇痛作用
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摘要
【目的】探讨亚甲蓝混合液联合中药痔瘘祛毒熏洗剂对混合痔外剥内扎术后患者的镇痛效果。【方法】将100例腰麻下行混合痔外剥内扎术的患者随机分为治疗组和对照组,每组各50例。2组患者均于手术结束时,在手术创缘注射亚甲蓝混合液,治疗组应用中药痔瘘祛毒熏洗剂坐浴,对照组应用温水坐浴。观察2组患者术后第1、2、3天排便状态下数字评分法(NRS)疼痛评分情况,以及术后追加止痛药物和尿潴留发生情况。【结果】(1)术后第1、2、3天,治疗组的NRS疼痛评分均低于对照组(P<0.01)。(2)治疗组患者术后追加止痛药物有5例(占10.0%),明显少于对照组的11例(占22.0%),差异有统计学意义(P<0.01)。(3)治疗组术后尿潴留发生率为26.0%,略低于对照组的30.0%,但组间比较,差异无统计学意义(P>0.05)。(4)治疗期间,2组患者均未见明显的不良反应。【结论】亚甲蓝混合液联合中药痔瘘祛毒熏洗剂治疗混合痔外剥内扎术后患者,镇痛效果理想,术后尿潴留发生率低,安全有效。
Objective To investigate the analgesic efficacy of methylene blue mixture combined with Hemorrhoid Fistula Detoxification Lotion in mixed hemorrhoid patients after Milligant-morgant hemorrhoidectomy. Methods One hundred mixed hemorrhoid patients after Milligant-morgant hemorrhoidectomy under lumbar anesthesia were randomized into treatment group and control group,50 cases in each group. At the end of the operation,the two groups were injected with methylene blue mixture around the surgical wound, and additionally, the treatment group was given sitz bath with Chinese herbal medicine of Hemorrhoid Fistula Detoxification Lotion and the control group was given sitz bath with warm water. The defecation pain on the 1 st,2 nd,and 3 rd day after the operation in the two groups was evaluated with the scores of Numeric Rating Scale(NRS). Moreover,the additional use of analgesic drugs and incidence of urinary retention after the operation in the two groups were observed. Results(1)On the 1 st,2 nd,and 3 rd day after the operation,the NRS defecation pain scores in the treatment group were lower than those in the control group(P<0.01).(2)The additional use of analgesic drugs after the operation occurred in 5 cases(10.0%)from the treatment group and in 11 cases(22.0%)from the control group, the difference being statistically significant(P<0.01).(3)The incidence of urinary retention after the operation in the treatment group was 26.0%,mildly lower than that in the control group(30.0%),and the difference was not significant(P>0.05).(4) During the treatment, no obvious adverse reaction occurred in the two groups.Conclusion The analgesic efficacy of methylene blue mixture combined with Hemorrhoid Fistula Detoxification Lotion is satisfactory for the treatment of mixed hemorrhoid patients after Milligant-morgant hemorrhoidectomy,having low incidence of urinary retention after the operation and being safe and effective.
Objective To investigate the analgesic efficacy of methylene blue mixture combined with Hemorrhoid Fistula Detoxification Lotion in mixed hemorrhoid patients after Milligant-morgant hemorrhoidectomy. Methods One hundred mixed hemorrhoid patients after Milligant-morgant hemorrhoidectomy under lumbar anesthesia were randomized into treatment group and control group,50 cases in each group. At the end of the operation,the two groups were injected with methylene blue mixture around the surgical wound, and additionally, the treatment group was given sitz bath with Chinese herbal medicine of Hemorrhoid Fistula Detoxification Lotion and the control group was given sitz bath with warm water. The defecation pain on the 1 st,2 nd,and 3 rd day after the operation in the two groups was evaluated with the scores of Numeric Rating Scale(NRS). Moreover,the additional use of analgesic drugs and incidence of urinary retention after the operation in the two groups were observed. Results(1)On the 1 st,2 nd,and 3 rd day after the operation,the NRS defecation pain scores in the treatment group were lower than those in the control group(P<0.01).(2)The additional use of analgesic drugs after the operation occurred in 5 cases(10.0%)from the treatment group and in 11 cases(22.0%)from the control group, the difference being statistically significant(P<0.01).(3)The incidence of urinary retention after the operation in the treatment group was 26.0%,mildly lower than that in the control group(30.0%),and the difference was not significant(P>0.05).(4) During the treatment, no obvious adverse reaction occurred in the two groups.Conclusion The analgesic efficacy of methylene blue mixture combined with Hemorrhoid Fistula Detoxification Lotion is satisfactory for the treatment of mixed hemorrhoid patients after Milligant-morgant hemorrhoidectomy,having low incidence of urinary retention after the operation and being safe and effective.
引文
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[6]勾娟,郑双清.肛周美蓝注射联合双氯芬酸钠栓肛塞在肛肠术后镇痛应用[J].山西医药杂志,2013,42(12):692.
[7]董亚静,高英雪,任慧如,等.舒芬太尼鞘内注射超前镇痛用于肛周手术术后镇痛的观察[J].河北医药,2013,35(5):682.
[8]胡安丽,贾莉,廖辉,等.亚甲蓝联合罗哌卡因对肛肠科术后镇痛的临床观察[C].国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会论文集(医学临床专集),2016.
[9]杨祎.肛门手术镇痛方式的研究[D].北京:北京中医药大学,2013.
[10]马伟伟.利多卡因加亚甲蓝对痔疮术后肛门疼痛的镇痛效果研究[J].中国生化药物杂志,2017,37(8):191.
[11]闫丽丽,傅绪珍,李思惠.急性苯的氨基和硝基化合物中毒27例临床分析[J].职业卫生与应急救援,2014,32(3):148.
[12]李俊,李亚玲,闻永等.复方亚甲蓝不同注射方式用于痔术后止疼效果的研究[J].实用药物与临床,2013,16(8):689.
[13]赵新生,江志峰,韩宝.局麻药复合亚甲蓝对肛肠术后烧灼痛的临床观察[J].世界中西医结合杂志,2011,6(11):978.
[14]孙平良,袁代解,耿曙光.亚甲蓝长效止痛合剂预防混合痔术后疼痛临床观察[J].亚太传统医药,2017,13(2):133.
[15]刘明武.黄帝内经素问原文注本[M].长沙:中南大学出版社,2007:97.
[16]郭智慧,于永铎,荣誉.三黄洗剂熏洗坐浴治疗肛肠术后并发症随机平行对照研究[J].实用中医内科杂志,2016,30(6):31.
[17]石宇,张虹玺.亚甲蓝混合液配合中药洗剂对混合痔术后镇痛的疗效观察[J].中医外治杂志,2018,27(1):30.
[18]任志国.混合痔术后多模式镇痛的临床研究[J].山东医学高等专科学校学报,2014,36(5):343.
[19]王培森,侯勇,王建民.亚甲蓝肛周皮下注射联合中药坐浴用于混合痔术后镇痛效果临床观察[J].中医药临床杂志,2018,30(2):329.
[20]张长磊.复方亚甲蓝联合中药熏洗法在混合痔外剥内扎术后镇痛的临床观察[D].济南:山东中医药大学,2016.
[21]张佩,龚春雨,刘洪.不同麻醉方式对痔疮手术患者术后恢复期舒适度的影响[J].四川大学学报(医学版),2018,49(4):627.
[22]周仲伍,张书.不同配伍亚甲蓝混合液治疗混合痔术后疼痛的效果观察[J].结直肠肛门外科,2018,24(2):199.
[23]赵忠玮.罗哌卡因、亚甲蓝及地塞米松混合液用于混合痔术后镇痛的疗效观察[J].沈阳医学院学报,2015,17(4):220.
[24]池进有,杨毅钧,吴玉英.复方亚甲蓝局部浸润麻醉在混合痔术后肛门疼痛中的临床应用[J].结直肠肛门外科,2016,22(4):354.
[2]赵宝林.加味芍药甘草汤治疗痔疮术后疼痛临床研究[J].中医学报,2010,25(6):1197.
[3]中华医学会外科分会结直肠肛门外科学组,中华中医药学会肛肠病专业委员会,中国中西医结合学会结直肠肛门病专业委员会.痔临床诊治指南(2006版)[J].中华胃肠外科杂志,2006,9(5):461.
[4]严广斌.NRS疼痛数字评价量表numerical rating scale[J].中华关节外科杂志(电子版),2014,8(3):410.
[5]庄建新,叶晋,李银辉.亚甲蓝联合罗哌卡因对混合痔术后镇痛的效果[J].实用临床医学,2016,17(2):38.
[6]勾娟,郑双清.肛周美蓝注射联合双氯芬酸钠栓肛塞在肛肠术后镇痛应用[J].山西医药杂志,2013,42(12):692.
[7]董亚静,高英雪,任慧如,等.舒芬太尼鞘内注射超前镇痛用于肛周手术术后镇痛的观察[J].河北医药,2013,35(5):682.
[8]胡安丽,贾莉,廖辉,等.亚甲蓝联合罗哌卡因对肛肠科术后镇痛的临床观察[C].国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会论文集(医学临床专集),2016.
[9]杨祎.肛门手术镇痛方式的研究[D].北京:北京中医药大学,2013.
[10]马伟伟.利多卡因加亚甲蓝对痔疮术后肛门疼痛的镇痛效果研究[J].中国生化药物杂志,2017,37(8):191.
[11]闫丽丽,傅绪珍,李思惠.急性苯的氨基和硝基化合物中毒27例临床分析[J].职业卫生与应急救援,2014,32(3):148.
[12]李俊,李亚玲,闻永等.复方亚甲蓝不同注射方式用于痔术后止疼效果的研究[J].实用药物与临床,2013,16(8):689.
[13]赵新生,江志峰,韩宝.局麻药复合亚甲蓝对肛肠术后烧灼痛的临床观察[J].世界中西医结合杂志,2011,6(11):978.
[14]孙平良,袁代解,耿曙光.亚甲蓝长效止痛合剂预防混合痔术后疼痛临床观察[J].亚太传统医药,2017,13(2):133.
[15]刘明武.黄帝内经素问原文注本[M].长沙:中南大学出版社,2007:97.
[16]郭智慧,于永铎,荣誉.三黄洗剂熏洗坐浴治疗肛肠术后并发症随机平行对照研究[J].实用中医内科杂志,2016,30(6):31.
[17]石宇,张虹玺.亚甲蓝混合液配合中药洗剂对混合痔术后镇痛的疗效观察[J].中医外治杂志,2018,27(1):30.
[18]任志国.混合痔术后多模式镇痛的临床研究[J].山东医学高等专科学校学报,2014,36(5):343.
[19]王培森,侯勇,王建民.亚甲蓝肛周皮下注射联合中药坐浴用于混合痔术后镇痛效果临床观察[J].中医药临床杂志,2018,30(2):329.
[20]张长磊.复方亚甲蓝联合中药熏洗法在混合痔外剥内扎术后镇痛的临床观察[D].济南:山东中医药大学,2016.
[21]张佩,龚春雨,刘洪.不同麻醉方式对痔疮手术患者术后恢复期舒适度的影响[J].四川大学学报(医学版),2018,49(4):627.
[22]周仲伍,张书.不同配伍亚甲蓝混合液治疗混合痔术后疼痛的效果观察[J].结直肠肛门外科,2018,24(2):199.
[23]赵忠玮.罗哌卡因、亚甲蓝及地塞米松混合液用于混合痔术后镇痛的疗效观察[J].沈阳医学院学报,2015,17(4):220.
[24]池进有,杨毅钧,吴玉英.复方亚甲蓝局部浸润麻醉在混合痔术后肛门疼痛中的临床应用[J].结直肠肛门外科,2016,22(4):354.