| Background:Mixed hemorrhoids are an anorectal disease with the highest incidence.When the symptoms and signs of prolapse of hemorrhoids or even incarcerated edema,severe pain,and blood in the stool have an impact on the patient’s life and life,and conservative treatment is ineffective,surgery should be the first choice,but postoperative pain often causes pain.The patient refused surgery due to fear.The surgical area of mixed hemorrhoids is on the skin of the anal canal called"pain sensitive area",and the nerve sensory fibers that control the hemorrhoids are abnormally sensitive.Intraoperative injury stimulation,postoperative defecation and dressing change cause sphincter spasm,resulting in severe pain,which is easy to cause Wound edema,difficulty in urinating and defecation,rapid heart rate,irritability,insomnia and other symptoms are interrelated and affect each other.Postoperative pain is the key to treatment.If pain management is not carried out in time,it will directly affect the postoperative quality of life and treatment outcomes.At present,there are many methods of postoperative analgesia in clinical practice,but they all have certain disadvantages.Therefore,it is necessary to constantly seek an analgesic method with clear curative effect,longer analgesic time,more convenient operation and more acceptable to patients.Objective:To observe the analgesic efficacy and postoperative complications of self-made traditional Chinese medicine prescription fumigation and washing combined with compound methylene blue perianal injection on postoperative pain of mixed hemorrhoids.Methods:100 experimental research subjects were selected from the patients who were diagnosed with mixed hemorrhoids and voluntary inpatient surgical treatment in the Anorectal Department of Hubei Provincial Hospital of Traditional Chinese Medicine from March 2021to December 2021,and were randomly divided into a treatment group（50 cases in total）and a control group group（50 cases in total）.All subjects in the study underwent RPH combined with external dissection and internal ligation of mixed hemorrhoids under spinal anesthesia.Compound methylene blue（2%methylene blue injection1ml+0.75%ropivacaine hydrochloride injection 5ml）was used in the anus after the operation.Weekly local injection,the treatment group was given a self-made Chinese herbal formula for clearing heat and dampness,reducing swelling and pain relief after defecation on the 2nd day after fumigation,taking a sitz bath,once a day;the control group was treated with 1:5000 permanganic acid after defecation on the 2nd day after surgery Potassium solution sitz bath,once a day.Observation and detailed records of the wound pain in the resting state and the first defecation on the 6h,1d,2d,3d,5d,7d,and 10d after the operation,and the wound surface after the sitz bath 2d,3d,5d,7d,and 10d after the operation were observed and recorded in detail.Pain,wound edema,constipation,anal function,postoperative analgesics,sleep quality,etc.Finally,the data were analyzed for statistical differences between groups.Results:Comparison of age,gender,course of disease,pain tolerance,number of postoperative hemorrhoid ligation and number of perianal incisions between the treatment group and the control group showed no statistically significant difference（P>0.05）,indicating comparability.Clinical studies showed that after independent samples t test,there was no statistically significant difference in the pain scores of the two groups in the resting state and the first defecation on the 6h and 1d after surgery（P>0.05）.There were statistically significant differences in the resting pain scores on the 2d,3d,5d,7d and 10d（P<0.05）,and the pain scores in the treatment group after sitz bath 2d,3d,5d,7d and10d after operation were lower than those in the control group（P<0.05）.TheX~2test was performed on the analgesic efficacy of the above time periods,and it was found that the analgesic efficacy of the 6h,1d and first defecation after the operation was not significantly different between the experimental groups（P>0.05）,but the statistical analysis was performed on the 2d,3d,5d,7d and10d of analgesic efficacy,the results were statistically significant differences between groups（P<0.05）.Comparing the postoperative complications such as difficulty in defecation and wound edema between the two groups,it was found that the treatment group was significantly lower than the control group,and the experimental results were statistically significant（P<0.05）.The two groups of patients were supplemented with analgesics at different time periods after the operation.Through the comparison of research data,it was found that the number and quantity of additional analgesics in the treatment group were less than those in the control group,and the experimental data between the groups was statistically different（P<0.05）.The insomnia rate of patients in the treatment group during hospitalization was 22.9%,and the insomnia rate of patients in the control group was 51.1%.It can be seen that the postoperative sleep quality of the patients in the treatment group was better than that in the control group,and the difference in experimental data was statistically significant（P<0.05）.There were no functional abnormalities such as anal incontinence in the two groups of patients during the observation period,and there was no significant difference in the data（P>0.05）.Conclusion:The analgesic effect of self-made traditional Chinese medicine prescription fumigation combined with compound methylene blue perianal injection is significantly better than compound methylene blue local injection combined with potassium permanganate sitz bath,and the analgesic effect of traditional Chinese medicine fumigation combined with compound methylene blue is longer,and it can also reduce the occurrence of postoperative complications such as wound edema and urinary retention,thereby alleviating the patient’s fear of pain,optimizing the patient’s quality of life after surgery,and having a positive significance for the construction of a"painless ward". |
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