门诊直肠外科手术干预中泻药选择的现代方法

B. M. Belik, A. Kovalev
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引用次数: 1

摘要

介绍。消除功能性便秘的表现,使大便正常化,至今仍是门诊直肠外科典型手术干预中一个复杂且最终未解决的问题。目的评价轻泻剂pico硫酸钠在门诊肛管直肠非肿瘤性疾病手术治疗中的临床疗效。材料和方法。将566例肛管直肠非肿瘤疾病患者分为两组,对其手术治疗结果进行分析。275例患者(第一组)在治疗过程中不使用泻药或不加选择地使用泻药。291例患者(第二组)在治疗期间使用轻泻剂picosulfate钠使结肠排空正常,大便软化。比较标准:术后疼痛综合征程度、手术干预领域炎症表现程度、粪便团块形状和性质(基于布里斯托量表)、伤口炎症并发症发生频率和患者恢复时间。术后早期,2组患者(89.7±4.1 ~ 94.2±5.1%)较1组患者(67.3±4.8 ~ 76.7±4.9%)出现较多的5、6型软化粘稠度。与此同时,2组患者疼痛症状较1组明显减轻,手术干预区炎症症状消退较快,创面炎症并发症发生率较1组下降2.8倍(由16.4%降至5.8%),工作能力恢复较1组早。结肠科患者在门诊对直肠肛管进行典型手术干预时,使用泻药picosulfate sodium,消除了症状性便秘的表现,保证了围手术期大便软化的形成,减少了粪便对直肠粘膜的机械损伤,降低了疼痛综合征的水平。通过减少伤口炎症并发症的数量,提高了手术治疗的效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Modern approach to the choice of laxative agent in surgical interventions in outpatient coloproctology
Introduction. Elimination of manifestations of functional constipation and normalization of the stool to date remain a complex and finally unresolved problem during typical surgical interventions in outpatient coloproctology.Aim. To evaluate the clinical efficacy of the laxative agent sodium picosulfate in the surgical treatment of non-tumor diseases of the anal canal and rectum in outpatient settings.Materials and methods. The results of surgical treatment of 566 patients with non-tumor diseases of the anal canal and rectum, which were divided into two groups, were analyzed. In 275 patients (group 1), laxative agents were not used during treatment or were used indiscriminately. In 291 patients (group 2), the laxative agent sodium picosulfate was used to normalize colon emptying and soften stools during treatment. Comparison criteria: level of pain syndrome after surgery, degree of inflammatory manifestations in the field of surgical intervention, shape, and nature of fecal masses (based on the Bristol scale), frequency of wound inflammatory complications and recovery time for patients.Results. In the early stages after surgery, the stool had a softened consistency (type 5 and 6) in a much larger number of group 2 patients (89.7 ± 4.1 – 94.2 ± 5.1%) compared with group 1 patients (67.3 ± 4.8 – 76.7 ± 4.9%). At the same time, in group 2 patients, pain syndrome was less pronounced, inflammatory manifestations in the area of surgical intervention regressed faster, incidence of wound inflammatory complications decreased 2.8 times (from 16.4 to 5.8%) and work capacity was recovered earlier than in group 1 patients.Conclusion. The use of the laxative agent sodium picosulfate in coloproctological patients when performing typical surgical interventions on the rectum and anal canal on an outpatient basis eliminates the manifestations of symptomatic constipation, ensures the formation of a softened stool in perioperative periods, reduces mechanical injury to the mucous membrane of the rectum by feces, reduces the level of pain syndrome, which improves the results of surgical treatment by reducing the number of wound inflammatory complications.
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