甲硝唑聯合地塞米松保留灌腸治療痔上黏膜環切術后肛門墜脹效果

胡志武

摘 要 目的：探討甲硝唑聯合地塞米松保留灌腸治療痔上黏膜環切術后肛門墜脹的效果。方法：收集2018年3月—2019年3月診治的痔上黏膜環切術后肛門墜脹患者70例，分對照組和觀察組各35例。對照組肛內注射甲硝唑50 ml保留灌腸，1次/d，5 d為1個療程。觀察組肛內注射甲硝唑50 ml和地塞米松注射液2.5 mg保留灌腸，1次/d，5 d為1個療程。比較兩組的治療效果、入院時及治療后肛門墜脹評分變化情況。結果：觀察組治療總有效率為97.14%（34/35），高于對照組的82.86%（29/35，P<0.05）。觀察組治療后1、3、5、7 d時的肛門墜脹評分均低于對照組（P<0.05）。結論：對于痔上黏膜環切術后肛門墜脹患者，通過甲硝唑聯合地塞米松保留灌腸治療，能夠獲得較好的療效，可在短時間內明顯改善患者的臨床癥狀，值得臨床推薦。

關鍵詞 痔瘡；痔上黏膜環切術；肛門墜脹；保留灌腸

中圖分類號：R266 文獻標志碼：A 文章編號：1006-1533（2020）12-0028-02

Effect of metronidazole combined with dexamethasone retention enema in the treatment of anal distention after circumcision of hemorrhoid mucosa

HU Zhiwu

（Surgical Department of Maternal and Child Health Care Hospital of Xinyu， Jiangxi Province 338025， China）

ABSTRACT Objective： To investigate the effect of metronidazole combined with dexamethasone retention enema in the treatment of anal distention after circumcision of hemorrhoid mucosa. Methods： Seventy patients with anal distention after circumcision of hemorrhoid mucosa were collected from March 2018 to March 2019 and divided into a control group and an observation group with 35 cases in each group. The control group received an intraanal injection of 50 ml metronidazole to retain the enema once a day， and 5 days was a course of treatment. In the observation group， 50 ml of metronidazole and 2.5 mg of dexamethasone were injected into the anus for retention enema once a day， and 5 days was a course of treatment. The therapeutic effect and the score of anal distention at admission and after treatment were compared between the two groups. Results： The total effective rate was 97.14%（34/35） in the observation group， which was higher than that 82.86%（29/35） in the control group（P<0.05）. The anus swell scores in the observation group at 1， 3， 5， and 7 days after treatment were lower than those in the control group（P<0.05）. Conclusion： For the patients with anal distention after circumcision of hemorrhoid mucosa， metronidazole combined with dexamethasone retention enema can achieve better curative effect， and significantly improve the clinical symptoms of patients in a short time， which is worthy of clinical recommendation.

KEY WORDS hemorrhoids； circumcision of hemorrhoid mucosa； anal distention； retention enema

痔瘡是臨床常見病，嚴重困擾患者的正常工作和生活，需及時進行治療。手術切除是治療痔瘡的常用手段，根據痔瘡類型不同可選擇不同的切除術式，其中痔上黏膜環切術是治療Ⅲ～Ⅳ度環狀脫垂型內痔的常用術式，具有創傷小、操作簡單、安全性高、術后恢復快等優點[1]。但該術式術后并發癥問題仍較為突出，患者術后常出現肛門墜脹，影響康復效果[2]。本文報道用甲硝唑聯合地塞米松保留灌腸治療肛門墜脹的療效。

1 資料與方法