自身对比法客观评估混合痔术后疼痛的临床探究.pdf

提 要 目的：客观评估混合痔外剥内扎术后患者的疼痛程度，探讨自身对比法对肛门病 术后疼痛评估的优势和可行性，为进一步推广该疼痛评估方法及改进手术方式打下基 础。 方法：本研究收集符合混合痔（Ⅱ~Ⅳ度内痔）行手术治疗的患者60例，依据麻 醉方式分为2组，每组各30例。一组在局麻下行混合痔外剥内扎术，简称局麻组；另 一组在腰麻或腰硬联合下行混合痔外剥内扎术，简称腰麻组。依据性别分为2组，其 中男性组41例，女性组19例。采用线性视觉模拟标尺观察患者不同部位术前及术后不 同时间的疼痛分值，对混合痔外剥内扎术后患者的疼痛程度作出客观评价。 结果：混合痔外剥内扎术患者局麻组和腰麻组术前穿刺静脉时疼痛值无显著性差 异；混合痔外剥内扎术患者男性组疼痛分值明显低于女性疼痛分值；混合痔外剥内扎 术患者术后疼痛差值男性组与女性组无明显差异；混合痔外剥内扎术患者麻醉时腰麻 组疼痛值明显低于局麻组疼痛值，患者在24h 内麻醉药品失去药效后的疼痛值，腰麻 组明显低于局麻组。混合痔外剥内扎术后患者疼痛最稳定的差值是患者自觉术后第一 次换药疼痛与术前穿刺静脉疼痛值的差，疼痛差值约为5。 结论：混合痔患者在局麻下行手术治疗后疼痛差值小，采用自身对比法能及时、 客观评估患者的疼痛程度。 关键词 自身对比法；混合痔；术后疼痛；客观评估 Clinical Study on Objective assessment of their comparative method of early postoperative pain mixed hemorrhoid Speciality: Surgery of TCM Tutor: Professor Guan Zhongan Author: Fan Mingfeng Abstract Objective: Objective assessment of the pain after outer peel and in rolling of mixed hemorrhoid patients, explore the self-comparison method postoperative pain assessment Anal advantages and feasibility of pain assessment in order to further promote the improvement of surgical methods and lay the foundation. Methods: Ⅱ Ⅳ The study collected consistent with mixed hemorrhoids ( ~ degree hemorrhoids) surgical treatment of 60 patients, divided into 2 groups according to anesthesia, 30 patients in each group. A group of local anesthesia outside the strip within the mixed hemorrhoid ligation, referred to as local anesthesia group; another group in the spinal or epidural stripping down outside the mixed hemorrhoid ligation, referred to as the spinal anesthesia group. Divided into 2 groups according to gender, male 41