目的 比较创面不同处理方法对痔术后创面疼痛及愈合的效果。方法 选取2015年1月—2017年12月收治的行手术治疗的重度混合痔患者440例,均行混合痔外剥内扎术。根据术后创面处理方法分为三组,分别采用痔痛安搽剂坐浴联合藻酸盐敷料换药、痔痛安搽剂坐浴联合聚维酮碘纱布换药及高锰酸钾溶液坐浴联合聚维酮碘纱布换药。分别于术后第1、3、5天坐浴后,采用视觉模拟评分法(VAS)评估患者的疼痛情况;比较两组患者第5天创面渗血、水肿及肉芽生长情况。结果 术后第1、3、5天,痔痛安搽剂坐浴联合藻酸盐敷料换药组患者VAS评分均低于痔痛安搽剂坐浴联合聚维酮碘纱布换药组和高锰酸钾溶液坐浴联合聚维酮碘纱布换药组患者同期VAS评分;痔痛安搽剂坐浴联合藻酸盐敷料换药组患者术后第5天创面渗血、水肿及肉芽生长情况均优于痔痛安搽剂坐浴联合聚维酮碘纱布换药组和高锰酸钾溶液坐浴联合聚维酮碘纱布换药组患者,差异有统计学意义(P＜0.05)。结论 痔痛安搽剂坐浴联合藻酸盐敷料换药对减少痔术后创面渗血、水肿、疼痛,促进肉芽组织的生长及缩短创面愈合时间等方面疗效优于痔痛安搽剂坐浴联合聚维酮碘纱布换药和高锰酸钾溶液坐浴联合聚维酮碘纱布换药。

Objective To compare the effects of different Methods on wound pain relief and healing after hemorrhoids operation.Methods A total of 440 severe mixed hemorrhoids patients from January 2015 to December 2017 were selected and given external dissection and internal ligation operation of mixed hemorrhoids.After operation, the cases were divided into three groups according to the wound treatment method they received: hemorrhoids sitz bath plus alginate dressing, hemorrhoids sitz bath plus povidone iodine gauze, and potassium permanganate sitz bath plus povidone iodine gauze.At 1, 3, and 5 days after sitz bath, the pain degree was evaluated by VAS; errhysis, edema, and granulation after 5 days were compared among the two groups.Results At 1, 3, and 5 days after operation, the VAS score of the patients in the hemorrhoids sitz bath plus alginate dressing group was significantly lower than the scores of the other two groups (P<0.05).At 5 days after operation, the development of errhysis, edema, and granulation of the patients in the hemorrhoids sitz bath plus alginate dressing group was superior to the other two groups (P<0.05).Conclusion Hemorrhoids sitz bath plus alginate dressing shows better healing effects on errhysis, edema, and granulation with shorter healing time post hemorrhoids operation than hemorrhoids sitz bath plus povidone iodine gauze and potassium permanganate sitz bath plus povidone iodine gauze.