肛周脓肿术后分期外用苦柏油与促愈油促进创面愈合的临床观察(1)
中图分类号 R45 文献标志码 A 文章编号 1001-0408(2018)02-0233-04
DOI 10.6039/j.issn.1001-0408.2018.02.21
摘 要 目的：探讨在肛周脓肿术后分期外用苦柏油与促愈油促进创面愈合的疗效和安全性。方法：选择成都市第三人民医院2014年1月-2016年1月收治的肛周脓肿患者125例为观察对象，按入院时间随机分为对照组(60例)、观察组(65例)。两组患者均接受肛周脓肿切开引流术或挂线引流术治疗；术后在常规治疗基础上，对照组患者采用庆大霉素纱条换药治疗，观察组患者在创面炎症期采用苦柏油纱条、在肉芽生长期与上皮生长期采用促愈油纱条换药治疗。治疗4周后，对两组患者治疗效果、创面愈合情况、伤口疼痛、创面分泌物、肉芽组织生长情况等进行比较，并记录不良反应发生情况。结果：观察组患者治愈率达到80.0%，显著高于对照组的63.3%(P<0.05)；创面面积减小率显著高于对照组，腐肉脱落时间、创面愈合时间均显著短于对照组(P<0.01或P<0.05)；术后第2、4周的伤口疼痛评分，第1、2、4周的创面分泌物评分、肉芽组织生长评分均显著低于对照组(P<0.01或P<0.05)。两组患者均未见明显不良反应发生。结果：对肛周脓肿术后患者分期外用苦柏油与促愈油，可以有效提高治疗效果，促进创面愈合，减轻术后疼痛，且安全性好。
关键词 肛周脓肿；术后；苦柏油；促愈油
ABSTRACT OBJECTIVE： To investigate therapeutic efficacy and safety of the use of Kubai oil and Cuyu oil by stages on wound healing after perianal abscess operation. METHODS： A total of 125 observation objects selected from Chengdu Third People’s Hospital during Jan. 2014-Jan. 2016 were randomly divided into control group (60 cases) and observation group (65 cases). Both groups received perianal abscess incision drainage or thread-drawing drainage. Control group was additionally given gentamicin gauze for dressing and other treatments after surgery based on routine treatment. Observation group was given Kubai oil gauze for dreassing in wound inflammation period， Cuyu oil gauze for dressing in granulation growth period and epithelial growth period. After 4 weeks of treatment， therapeutic efficacy， wound healing， wound pain， wound secretion and the growth of granulation tissue were compared between 2 groups. The occurrence of ADR was also recorded. RESULTS： The cure rate of observation group reached 80.0%， which was significantly higher than 63.3% of control group (P<0.05)； the reduction rate of wound area was significantly higher than control group， while the carrion shedding time and wound healing time were significantly lower than control group (P<0.01 or P<0.05). The wound pain score in 2nd， 4th week， the wound secretion score and granulation tissue growth score in 1st， 2nd， 4th week after operation were significantly lower than control group (P<0.01 or P<0.05). No significant ADR was found in 2 groups. CONCLUSIONS： For the patients underwent perianal abscess operation， the use of Kubai oil and Cuyu oil by stages can effectively improve therapeutic efficacy and wound healing， and relieve postoperative pain with good safety.
KEYWORDS Perianal abscess； After operation； Kubai oil； Cuyu oil
肛周膿肿是一类发生于肛管或直肠周围软组织，间歇的急性或慢性化脓性感染，是临床较常见的多发性肛周疾病，在肛肠疾病中的占比可达30%[1]。肛周脓肿不能自愈，在早期使用抗生素等保守治疗也仅能延迟化脓时间，不能避免脓肿形成，所以手术是目前治疗肛周脓肿最有效的方法[2]。脓肿切开引流术、挂线引流术等根治性手术为保证将脓液完全引流，往往需要较大的手术创面。但由于病变的特殊位置，创面不易保持干燥，且局部细菌种类和数量较多，加之排便等影响因素，容易导致术后创面愈合延迟[3]。肛周脓肿术后创面换药治疗被认为是创面愈合的关键因素。我国传统医学中医药通过去腐、生肌、长皮等过程参与到创面愈合的病理生理学过程，临床效果明显。基于此，本研究应用根据古方苦参汤加减、生肌玉红膏加减制备的外用药剂苦柏油、促愈油，用于肛周脓肿术后治疗，取得较好效果，现报道如下。, 百拇医药(陈婷 李五生)
DOI 10.6039/j.issn.1001-0408.2018.02.21
摘 要 目的：探讨在肛周脓肿术后分期外用苦柏油与促愈油促进创面愈合的疗效和安全性。方法：选择成都市第三人民医院2014年1月-2016年1月收治的肛周脓肿患者125例为观察对象，按入院时间随机分为对照组(60例)、观察组(65例)。两组患者均接受肛周脓肿切开引流术或挂线引流术治疗；术后在常规治疗基础上，对照组患者采用庆大霉素纱条换药治疗，观察组患者在创面炎症期采用苦柏油纱条、在肉芽生长期与上皮生长期采用促愈油纱条换药治疗。治疗4周后，对两组患者治疗效果、创面愈合情况、伤口疼痛、创面分泌物、肉芽组织生长情况等进行比较，并记录不良反应发生情况。结果：观察组患者治愈率达到80.0%，显著高于对照组的63.3%(P<0.05)；创面面积减小率显著高于对照组，腐肉脱落时间、创面愈合时间均显著短于对照组(P<0.01或P<0.05)；术后第2、4周的伤口疼痛评分，第1、2、4周的创面分泌物评分、肉芽组织生长评分均显著低于对照组(P<0.01或P<0.05)。两组患者均未见明显不良反应发生。结果：对肛周脓肿术后患者分期外用苦柏油与促愈油，可以有效提高治疗效果，促进创面愈合，减轻术后疼痛，且安全性好。
关键词 肛周脓肿；术后；苦柏油；促愈油
ABSTRACT OBJECTIVE： To investigate therapeutic efficacy and safety of the use of Kubai oil and Cuyu oil by stages on wound healing after perianal abscess operation. METHODS： A total of 125 observation objects selected from Chengdu Third People’s Hospital during Jan. 2014-Jan. 2016 were randomly divided into control group (60 cases) and observation group (65 cases). Both groups received perianal abscess incision drainage or thread-drawing drainage. Control group was additionally given gentamicin gauze for dressing and other treatments after surgery based on routine treatment. Observation group was given Kubai oil gauze for dreassing in wound inflammation period， Cuyu oil gauze for dressing in granulation growth period and epithelial growth period. After 4 weeks of treatment， therapeutic efficacy， wound healing， wound pain， wound secretion and the growth of granulation tissue were compared between 2 groups. The occurrence of ADR was also recorded. RESULTS： The cure rate of observation group reached 80.0%， which was significantly higher than 63.3% of control group (P<0.05)； the reduction rate of wound area was significantly higher than control group， while the carrion shedding time and wound healing time were significantly lower than control group (P<0.01 or P<0.05). The wound pain score in 2nd， 4th week， the wound secretion score and granulation tissue growth score in 1st， 2nd， 4th week after operation were significantly lower than control group (P<0.01 or P<0.05). No significant ADR was found in 2 groups. CONCLUSIONS： For the patients underwent perianal abscess operation， the use of Kubai oil and Cuyu oil by stages can effectively improve therapeutic efficacy and wound healing， and relieve postoperative pain with good safety.
KEYWORDS Perianal abscess； After operation； Kubai oil； Cuyu oil
肛周膿肿是一类发生于肛管或直肠周围软组织，间歇的急性或慢性化脓性感染，是临床较常见的多发性肛周疾病，在肛肠疾病中的占比可达30%[1]。肛周脓肿不能自愈，在早期使用抗生素等保守治疗也仅能延迟化脓时间，不能避免脓肿形成，所以手术是目前治疗肛周脓肿最有效的方法[2]。脓肿切开引流术、挂线引流术等根治性手术为保证将脓液完全引流，往往需要较大的手术创面。但由于病变的特殊位置，创面不易保持干燥，且局部细菌种类和数量较多，加之排便等影响因素，容易导致术后创面愈合延迟[3]。肛周脓肿术后创面换药治疗被认为是创面愈合的关键因素。我国传统医学中医药通过去腐、生肌、长皮等过程参与到创面愈合的病理生理学过程，临床效果明显。基于此，本研究应用根据古方苦参汤加减、生肌玉红膏加减制备的外用药剂苦柏油、促愈油，用于肛周脓肿术后治疗，取得较好效果，现报道如下。, 百拇医药(陈婷 李五生)
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