混合痔术后创缘水肿和出血原因分析

为分析患者混合痔术后肛门创缘水肿、出血与肛门括约肌痉挛程度和直肠内压力的关系，将400例混合痔患者分为术后留置镇痛泵组和不留置镇痛泵组，各200例，进行肛门创缘水肿和出血情况的比较。400例患者术后按首次排便时间分为：①组〈24h84例；②组25～48h236例；③组〉48h80例，观察患者术后排便时间与肛门创缘水肿和出血的关系。结果显示，留置镇痛泵组和不留置镇痛泵组患者术后创缘水肿情况差异有统计学意义（P〈0．05）。患者术后首次排便时间与肛门创缘水肿和出血的关系，②组与①组和③组比较差异均有统计学意义（P〈0．05）。结果表明，留置镇痛泵组患者和术后排便时间在25～48h的患者肛门创缘水肿情况发生率明显下降。术后首次排便时间在25～48h既能减轻创缘水肿，又能减少创缘出血。

Analysis on the Causes Inducing Wound-edge Edema and Bleeding after the Surgery for Mixed Hemorrhoids

In order to explore the relationship of postoperative anal wound-edge edema, bleeding in mixed hemorrhoid patients with the spasm degree of anal sphincter, and with intrarectal pressure,authors divided 400 patients to be subjected to surgery into the group with analgesic pump and the group without analgesic pump,200 cases for each group,and compared wound-edge edema, bleeding incidence of both groups; Also, 400 cases were divided into A,B,C group according to the time for the first time defecation after operation： group A（ n =84） the time 〈24h,group B（ n =236） the time was 25-48h,group C（ n =80） the time〉48h, then analysed the relationship of the time for defecation after operation with anal wound-edge edema and bleeding. As results, 1）between the group with pump and without pump there was statistical difference in the status on anal wound-edge edema（ P 〈0.05） ;2）in the relationship of the time for the first time defecation with anal wound-edge edema and bleeding compared with group A and C, group B had significant difference（ P 〈0. 05）. Results show that the incidence of anal wound-edge edema of the patients with pump and the patients of group B was significantly decreased,at 25-48h after operation the first time defecation not only can reduce the incidence of edema, but bleeding.