甲硝唑联合地塞米松保留灌肠治疗痔上黏膜环切术后肛门坠胀效果

胡志武

摘 要 目的：探讨甲硝唑联合地塞米松保留灌肠治疗痔上黏膜环切术后肛门坠胀的效果。方法：收集2018年3月—2019年3月诊治的痔上黏膜环切术后肛门坠胀患者70例，分对照组和观察组各35例。对照组肛内注射甲硝唑50 ml保留灌肠，1次/d，5 d为1个疗程。观察组肛内注射甲硝唑50 ml和地塞米松注射液2.5 mg保留灌肠，1次/d，5 d为1个疗程。比较两组的治疗效果、入院时及治疗后肛门坠胀评分变化情况。结果：观察组治疗总有效率为97.14%（34/35），高于对照组的82.86%（29/35，P<0.05）。观察组治疗后1、3、5、7 d时的肛门坠胀评分均低于对照组（P<0.05）。结论：对于痔上黏膜环切术后肛门坠胀患者，通过甲硝唑联合地塞米松保留灌肠治疗，能够获得较好的疗效，可在短时间内明显改善患者的临床症状，值得临床推荐。

关键词 痔疮；痔上黏膜环切术；肛门坠胀；保留灌肠

中图分类号：R266 文献标志码：A 文章编号：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

痔瘡是临床常见病，严重困扰患者的正常工作和生活，需及时进行治疗。手术切除是治疗痔疮的常用手段，根据痔疮类型不同可选择不同的切除术式，其中痔上黏膜环切术是治疗Ⅲ～Ⅳ度环状脱垂型内痔的常用术式，具有创伤小、操作简单、安全性高、术后恢复快等优点[1]。但该术式术后并发症问题仍较为突出，患者术后常出现肛门坠胀，影响康复效果[2]。本文报道用甲硝唑联合地塞米松保留灌肠治疗肛门坠胀的疗效。

1 资料与方法