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無創痔瘡治療儀治療老年嵌頓痔的療效觀察
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無創痔瘡治療儀治療老年嵌頓痔的療效觀察

譚正洋高貴云,向麗,劉偉英,周文超,丁玲,鄧如丹

(湖南航天醫院,湖南長沙410200)

[摘要] 目的 觀察無創痔瘡治療儀治療老年嵌頓痔的臨床療效。方法 采用隨機對照的試驗方法,將80 例老年嵌頓痔患者隨機分為治療組和對照組,每組各40 例。治療組采用無創痔瘡治療儀綜合物理治療,對照組馬應龍麝香痔瘡膏外涂和塞肛。兩組均治療3天后比較治療效果。結果 肛門疼痛VAS評分、異物感和墜脹感評分、痔核大小變化評分的組內比較,兩組方法均有治療作用(P<0.01),兩組治療后3天療效的組間比較,治療組優于對照組(P<0.01)。治療組治療3天,顯效16例,有效21例,總有效率92.5%;對照組治療3天,顯效3例,有效26例,總有效率72.5%。兩組療效比較差異有統計學意義(P<0.01)結論 無創痔瘡治療儀綜合物理治療可快速改善痔核腫痛和嵌頓癥狀,方法簡便,無明顯副作用,是一種治療老年嵌頓痔好方法。

[關鍵詞] 無創痔瘡治療儀;老年;嵌頓痔;混合痔 

Clinical observation on Curative Effect of Incarcerated Hemorrhoids in elderly patients with non traumatic hemorrhoids

Tan zheng-yang,Gao Gui-yun,Xiangli, et al.Department of Anorectal, Hunan aerospace hospitalchangsha,410205

Abstract: Objective To observe the clinical efficacy of noninvasive therapy for the treatment of hemorrhoids in elderly Incarcerated Hemorrhoids. Methods A randomized clinical trial, 80 patients with incarcerated hemorrhoids were randomly divided into treatment group and control group, 40 cases in each group. The treatment group were treated by noninvasive hemorrhoids treatment instrument comprehensive physical treatment, control group musk Hemorrhoids Ointment and anus. Two groups were treated for 3 days, the therapeutic effects were compared. Results Anal pain VAS score, foreign body sensation and tenesmus score, comparison group score changes the size of hemorrhoids, two groups were treatment method (P<0.01), the two groups after 3 days treatment between the two groups, the treatment group than the control group (P<0.01). The treatment group was 3 days, 16 cases were markedly effective, effective in 21 cases, the total efficiency of 92.5%; the control group after 3 days of treatment, 3 cases were cured, 26 cases were effective, the total efficiency of the 72.5%. Effect of the two groups had significant difference (P<0.01). Conclusion Noninvasive comprehensive physical therapy instrument for the treatment of hemorrhoids hemorrhoids can quickly improve the symptoms of swelling and incarceration, the method is simple, no obvious side effects that is a good method for elderly Incarcerated Hemorrhoids.

 Key words: non invasive hemorrhoids treatment instrument; old age; Incarcerated Hemorrhoids; mixed hemorrhoids

 

痔瘡是臨床老年人發病率較高的疾病之一。老年人痔瘡發病特點是發病時間長,痔瘡數目較多,反復脫出、便血。因慢性病程,老年人平時多不重視治療。故老年人多以手術難度大的環狀混合痔并嵌頓來就診。針對老年患者,采用一種痛苦小、癥狀改善快非手術療法,很有必要。我科2015 9-201712月采用無創痔瘡治療儀治療老年嵌頓痔患者80 例,取得滿意療效,現報道如下。

1 臨床資料

1.1 診斷標準 按《痔臨床診治指南(2006) 》混合痔及度內痔的診斷標準[1]。納入標準:(1)混合痔及Ⅳ度內痔嵌頓腫痛的患者。(2)均簽署知情同意書,自愿或同意非手術治療,并同意治療。排除標準:(1)合并中風急性期、心功能衰竭、呼吸衰竭、腎功能衰竭等嚴重疾病;(2)合并肛周膿腫、肛裂、肛管惡性腫瘤、直腸脫垂等疾病,或痔瘡已嵌頓壞死或形成膿腫。(3)要求手術及其它治療。

1.2 臨床資料  選擇上述時期收治的老年嵌頓痔患者80例,按照隨機數字表法分為2 : 治療組40例,男22例,女18; 年齡(70.76±8.52) 歲。對照組40例,男21例,女19; 年齡( 71.12±8. 80) 歲。2組一般資料比較差異無統計學意義( P 均>0. 05) ,具有可比性。

1.3 治療方法  兩組均住院或門診治療,注意控制血壓、血糖在正常范圍。

1.3.1對照組 予以手法復位后,用馬應龍麝香痔瘡膏外涂痔核表面和塞肛,早晚各1次。連續用藥3天后觀察療效。

1.3.2治療組  予以手法復位后,采用XCZL-020 型無創痔瘡治療儀(湖南朗普醫學科技有限公司生產)。將馬應龍麝香痔瘡膏涂到肛門及外痔核表面,將治療探頭用衛生套包裹并涂上馬應龍麝香痔瘡膏以靶向透藥,緩緩插入肛門。開機后,按單項調節將激光、熱敷、磁旋數值分別調至204515。然后開始治療,操作人員全程看護,并根據患者舒適度,適當調節溫度、旋磁強度及激光數值大小。每次治療15分鐘,12次,間隔時間3小時以上,3天為1個療程,明顯腫大者可以治療2個療程

1.4 觀察方法 觀察記錄兩組治療前及治療3天后主要癥狀和體征變化。疼痛評分采用VAS 評分標尺,患者根據自己的痛覺自行判定后告訴醫生疼痛所在的位置,由醫生在標尺上進行標注。疼痛程度以10 為標尺,10 為極度疼痛,0為不痛。肛門異物感和墜脹感評分[2],根據程度分為重度、中度、輕度、正常,分別記43

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