- 期刊
連續1000例痔瘡手術後評估
Post - Operative Evaluation of 1000 Consecutive Hemorrhoid Cases
摘要
從72年9月到77年10月止，共有連續一千例接受痔瘡手術的住院病患，依據其病歷記錄做一回溯性評估，主要對於其性別、年齡、手術方式、術後疼痛、併發症及住院日數等各項資料，分別分析比較。手術方式以楔狀切除術（wedge hemorrhoidectomy）與肛門成形術（anoplasty）為主。而楔狀切除術又包含兩種一、開放性痔瘡切除術（open hemorrhoidectomy, O.H. ）(1)，二、封閉性痔瘡切除術（closed hemorroidectomy, C.H. ）。肚門成形術括部分肛門成形術（partial anoplasty, P.A. ）或楔狀切除術加上部分肛門成形術，以及全肛肛門成形術（total anoplasty，Whitehead hemorrhoidectomy, T.A. ）。我們發現手術範圍愈大、則術後發生早期的併發症愈嚴重。如接受肛門成形術的病人，術後有78.1%產生尿滯留、有79.4%發生糞便阻塞等併發症。晚期併發症在兩種手術方式間無太大差異。在住遠天數上，肚門成形術亦較長，平均8.4天。因此，對放痔瘡的手術治療，在手術方式選擇上，愈簡單愈好，且盡量避免肛門成形術。而手術方式又以楔狀切除術中的open hemorrhoidectomy 最好。不但可減少病人術後的病苦，也可減少病人住院天數，以符合經濟效益。
關鍵字
無資料並列摘要
From September 1983 to October 1988, one thousand consecutive hemorrhoid patients were hospitalized and treated at T.C.V.G..H.A retrospective evaluation based on their admission charts was conducted. Two surgical procedures, wedge hemorrhoidectomy and anoplasty, were compared. We collected and analyzed the following data: sex, age, surgical procedure, post-operative pain, complications and number of days of hospitalization. This study discovered that the larger the major operative area and the greater the numbed of suture knots, the severer the post-operative pain. For instance, anoplasties resulted in a higher incidence of urine retention (78.1%) and stool impaction (79.4%) than hemorrhoidectomies did. Early complications were found primarily in cases receiving anoplasty, but in iater complications there were no significant differences found between procedures. Anoplasty also resulted in a longer hospital stay, 50 when dealing with th same degree of hemorrhoid, the simpler the operation, the better the result, because the patients’ discomfort can be reduced and hospitalization can be shortened.