气相色谱法测定马应龙麝香痔疮膏中龙脑的含量

目的:建立马应龙麝香痔疮膏中龙脑的含量测定方法.方法:气相色谱法,2 m×3 mm不锈钢柱,15%丁二酸二乙二醇聚酯(DEGS)Chromsorb W-AW(80～100目),柱温105℃,进样口温度250℃,FD检测器,载气为氮气.结果:平均回收率为99.92%(n=6),RSD为0.65%.结论:本法简便高效,结果准确可靠,可用于本品的质量控制.     

PPH吻合器治疗严重脱垂性内痔的疗效对比

目的：探讨PPH吻合器治疗严重脱垂性内痔的疗效。方法严重脱垂性内痔患者90例根据治疗方法的不同分为治疗组与对照组各45例，治疗组采用PPH吻合器治疗，对照组采用外剥内扎法治疗。结果两组手术经过均顺利，无麻醉意外，都痊愈出院。不过治疗组的手术时间、术后住院时间与术中缝扎止血例数明显少于对照组，差异有统计学意义（P＜0.05）。治疗组术后疼痛、水肿与尿潴留的发生率明显少于对照组，差异有统计学意义（P＜0.05）。结论PPH吻合器治疗严重脱垂性内痔创伤少，患者恢复快，术后安全性好，是一种微创、安全、有效的手术方法。     

优质护理在混合痔围手术期患者中的应用价值分析

目的：探讨分析优质的护理在混合痔围手术期患者中的应用价值。方法：选取2013年1月～2014年1月我院接受治疗的68例混合痔患者，随机分为试验组（优质护理组，试验例数为34）和对照组（常规护理组，试验例数为34），利用统计学方法对此两种护理方式下患者的术前精神状态和术后并发症发生率等进行比较分析。结果：试验组通过优质精心的护理，试验组混合痔患者的术前精神状态和并发症发生率明显优于对照组，且术后住院时间也低于对照组，两组对比具有显著差异性（P〈0．05），具有统计学意义。结论：通过优质精心的护理，可有效地促进手术创面的愈合，有利于患者的旱日康复，避免各种并发症的发生，值得在临床上应用和推广。     

自动痔疮套扎术结合外痔切除术治疗混合痔患者的临床疗效研究

目的：探讨自动痔疮套扎术结合外痔切除术治疗混合痔患者的实际效果。方法随机选取2012年6月—2014年6月该院收治的混合痔患者50例,按硬币法将其分成实验组25例,对照组25例,实验组联合应用自动痔疮套扎术、外痔切除术治疗,对照组应用外切内扎术治疗,比较两组混合痔治疗效果。结果实验组混合痔治疗有效率为100.0%,与对照组的96.0%相比,差异无统计学意义;实验组尿潴留、术后出血、肛门直肠狭窄并发症发生率为12.0%,与对照组相比,差异有统计学意义（P<0.05）。结论自动痔疮套扎术结合外痔切除术治疗混合痔患者,效果满意,值得临床进一步应用、推广。     

分段切除伴肛门整形术治疗环状外痔为主混合痔的远期疗效观察

目的 评价分段切除伴肛门整形术治疗环状外痔为主混合痔的远期疗效.方法 采用多中心随机对照试验,将符合环状外痔为主混合痔的300例患者随机分为试验组和对照组,每组各150例,试验组采用分段切除伴肛门整形术,对照组采用混合痔外剥内扎术.术后1年及18个月随访,观察两组术后肛门狭窄、肛门功能、旺门平整度及满意度情况.结果 两组患者在肛门功能、肛门平整度和满意度上,差异有统计学意义(P＜0.05).结论 分段切除伴肛门整形术治疗环状外痔为主混合痔,远期疗效确切,术后随访并发症少,患者满意度高.     

Clinical study of herbal mixture “Diding Oral Medicine” as an alternative to preventative antibiotics in perioperative hemorrhoids: A CARE-compliant article

To study the clinical effects of Diding Oral Medicine as an alternative to preventative antibiotics in perioperative hemorrhoids.From August 2017 to February 2018, a total of 214 patients who were treated with external exfoliation and internal ligation of mixed hemorrhoids in our hospital were divided into the control group and experimental group by way of stratified random (107 cases in each group). Patients in the control group were given antibiotics preventatively before operation, while patients in the experimental group took Diding Oral Medicine before operation, and the white blood cell count, neutrophil count, wound recovery, pain score, anal bulge score, and pathogen culture of wound secretions were compared between the 2 groups.There was no significant difference in white blood cell count and neutrophil count between both groups before and after operation (P > .05). The wound seepage score, wound edema score, and wound area score in the experimental group were lower than those in the control group, and the wound healing in the experimental group was shorter than that in the control group (all P < .05). The pain score and anal bulge score of the experimental group were decreased significantly compared to the control group (P < .05). In addition, the detection rate of pathogenic bacteria in the experimental group was downregulated significantly compared to the control group (P < .05).The Diding Oral Medicine has prominent bacteriostatic and antibacterial effects on patients with hemorrhoids during perioperative period, and promotes wound healing, reduces pain stress, and anal bulge.     

痔上黏膜环型切除术和外剥内扎术治疗重度痔疮疗效观察

目的 探讨痔上黏膜环型切除术(PPH)与外剥内扎术(MMH)治疗重度(Ⅲ、Ⅳ度)痔疮的临床疗效.方法 选取Ⅲ、Ⅳ度痔疮患者152例,依据治疗术式不同分为PPH组和MMH组,分别采用PPH术及MMH术治疗,对比2组术中、术后情况及疼痛视觉模拟(VAS)评分.结果 PPH组手术时间、术中出血量、住院时间显著低于MMH组(P＜0.05);PPH组术后疼痛、尿潴留、肛门下坠感、便后出血及肛门狭窄发生率均显著低于MMH组(P＜0.01);PPH组术后3、7d切口肿胀评分、VAS评分均优于MMH组(P＜0.05).结论 PPH术治疗重度痔疮手术用时短、术中出血少,术后疼痛轻且并发症发生率低.     

A Prospective,Randomized, Controlled Multicenter Trial Comparing Stapled Hemorrhoidopexy and Ferguson Hemorrhoidectomy: Perioperative and One-Year Results

PURPOSE There is a growing body of evidence supporting the lesser degrees of pain with stapled hemorrhoidopexy, also called the procedure for prolapse and hemorrhoids. However, there have been few randomized comparisons assessing both perioperative and long-term outcomes of the procedure for prolapse and hemorrhoids and Ferguson hemorrhoidectomy. Results are presented here from the first prospective, randomized, multicenter trial comparing these hemorrhoid procedures in the United States.METHODS Patients with prolapsing hemorrhoids (Grade III) were randomized to undergo the procedure for prolapse and hemorrhoids or Ferguson hemorrhoidectomy by colorectal surgeons who had training in using the stapling technique. Primary end points were acute postoperative pain, and hemorrhoid symptom recurrence requiring additional treatment at one-year follow-up from surgery.RESULTS A total of 156 patients (procedure for prolapse and hemorrhoids, 77; Ferguson, 79) completed randomization and the surgical procedure, 18 (procedure for prolapse and hemorrhoids, 12; Ferguson, 6) had significant protocol violations. One hundred seventeen patients (procedure for prolapse and hemorrhoids, 59; Ferguson, 58) returned for one-year follow-up. Demographic parameters, hemorrhoid symptoms, preoperative pain scores, and bowel habits were similar between groups. There were a similar number of patients with adverse events in each group (procedure for prolapse and hemorrhoids, 28 (36.4 percent) vs. Ferguson, 38 (48.1 percent); P = 0.138). Reoperation for an adverse effect was required in six (7.6 percent) Ferguson patients and in 0 patients having the procedure for prolapse and hemorrhoids (P = 0.028). Postoperative pain during the first 14 days, pain at first bowel movement, and need for postoperative analgesics were significantly less in the procedure for prolapse and hemorrhoids group. Control of hemorrhoid symptoms was similar between groups; however, significantly fewer patients having the procedure for prolapse and hemorrhoids required additional anorectal procedures during one-year follow-up (procedure for prolapse and hemorrhoids, 2 (2.6 percent), vs. Ferguson, 11 (13.9 percent); P = 0.01). Only four of the Ferguson patients (5 interventions) required additional procedures more than 30 days after surgery.CONCLUSIONS These data demonstrate that stapled hemorrhoidopexy offers the benefits of less postoperative pain, less requirement for analgesics, and less pain at first bowel movement, while providing similar control of symptoms and need for additional hemorrhoid treatment at one-year follow-up from surgery.Supported by Ethicon Endo-Surgery, Cincinnati, Ohio.Read at the meeting of The American Society of Colon and Rectal Surgeons, Chicago, Illinois, June 3 to 8, 2002. Winner of The New England Society of Colon and Rectal Surgeons Award.     

外剥内扎硬注术治疗环状混合痔的临床效果

目的探讨外剥内扎硬注术治疗环状混合痔的临床效果。方法选取2017年1月至2018年12月广州市荔湾区中医医院广雅院区收治的环状混合痔患者96例,按随机数字表法分为2组:对照组48例采取外剥内扎术治疗,观察组48例采取外剥内扎硬注术治疗。比较2组术后视觉模拟评分量表（VAS）评分、伤口愈合时间以及手术并发症发生率。结果与对照组比较,观察组术后不同时间VAS评分均明显降低、伤口愈合时间明显缩短、术后并发症发生率明显降低,差异有统计学意义（均P<0.05）。结论外剥内扎硬注术在环状混合痔临床治疗中具有较好的应用效果,能够降低患者术后疼痛程度,减少术后并发症的发生率。     

吻合器痔上黏膜环切术(PPH)治疗重度痔术后并发症分析(附384例报告)

目的探讨PPH术后并发症的原因及防治体会。方法回顾性分析2011-01—2013-12间实施PPH术治疗的384例重度痔患者术后并发症的情况。结果尿潴留81例(21.1%),肛门疼痛需用止痛剂165例(42.9%),术后原发性出血4例(1.1%),术后继发性出血7例(1.8%),肛门残留皮赘或仍有轻度痔核脱垂18例(4.7%),肛门狭窄2例(0.5%),直肠阴道瘘1例。随访10~30个月,有2例再次入院行痔切除术。结论 PPH术虽具有操作简便,创伤小、恢复快等优点,但仍需进一步规范手术操作及围手术期处理,减少并发症发生。