刘军艳　张胜茹

〔摘要〕 目的 研究中西医结合护理对肛瘘术后伤口愈合、便秘預防、疼痛程度的作用。方法 选取2015年6月至2018年6月安康市中心医院收治的100例肛瘘切除术后患者为对象，采用随机数字法将其分为对照组和观察组，每组50例。对照组给予常规西医护理，观察组给予中西医结合护理，比较两组术后恢复情况、VAS评分、预防便秘效果及并发症发生率。结果 干预后观察组创面愈合时间、红肿消退时间、脓性分泌物消失时间、便血时间及住院时间均短于对照组（P<0.05）;观察组术后6 h、12 h、24 h、48 h及72 h的VAS评分均显著低于对照组（P<0.05）;干预后观察组预防便秘有效率为92.0%，显著高于对照组的76.0%（P<0.05）;观察组并发症总发生率为8.0%，显著低于对照组的24.0%（P<0.05）。结论 中西医结合护理不仅能够促进肛瘘术后伤口愈合，还可预防便秘，缓解疼痛程度，减少并发症发生率。

〔关键词〕 肛瘘;中西医结合护理;伤口愈合;便秘

〔中图分类号〕R266;R473.6       〔文献标志码〕B       〔文章编号〕doi：10.3969/j.issn.1674-070X.2019.09.023

Application Effects of Integrated Traditional Chinese and Western Medicine Nursing on Pain

Degree and Constipation Prevention after Anal Fistula Operation

LIU Junyan1， ZHANG Shengru2*

（1. School of Nursing， Ankang Vocational and Technical College， Ankang， Shaanxi 725000， China;

2. Urinary Surgery， Ankang Central Hospital， Ankang， Shaanxi 725000， China）

〔Abstract〕 Objective To study the effects of integrated traditional Chinese and western medicine nursing on wound healing， constipation prevention and pain degree after anal fistula operation. Methods A total of 100 patients with anal fistula after operation admitted in Ankang Central Hospital from June 2015 to June 2018 were selected as subjects， and they were randomly divided into a control group （n=50） and an observation group （n=50） by random number method. The control group was given routine western medicine nursing， while the observation group was given integrated traditional Chinese and western medicine nursing. Recovery situation， VAS score， efficacy of preventing constipation and incidence of complication were compared between the 2 groups after the operation. Results After the intervention， the wound healing time， swelling subsidence time， purulent secretion disappearance time， hematochezia time and hospitalization time in the observation group were shorter than those in the control group （P<0.05）; the VAS scores in the observation group at 6 h， 12 h， 24 h， 48 h and 72 h after the operation were significantly lower than those in the control group （P<0.05）; after the intervention， the effective rate of constipation prevention in the observation group was 92.0%， which was significantly higher than 76.0% in the control group （P<0.05）; the total incidence of complication in the observation group was 8.0%， which was significantly lower than 24.0% in the control group （P<0.05）， Conclusion Integrated traditional Chinese and western medicine nursing can not only promote wound healing after anal fistula operation， but also prevent constipation， relieve pain and reduce the incidence of complication.

〔Keywords〕 anal fistula; integrated traditional Chinese and Western medicine nursing; wound healing; constipation

肛瘘又称为肛门直肠瘘，是发生在肛门直肠周围的脓肿溃破或切口引流的后遗病变，多发于20～40岁人群，常由肛周脓肿、直肠肛门损伤、肛门裂开反复感染等因素引发。临床主要表现为疼痛、瘙痒、红肿、流脓等症状[1]，据相关报道显示，肛瘘在肛门直肠疾病的发病率仅次于痔，占一半外科疾病的3%～5%[2]。目前，临床上常采用手术治疗，但术后可导致切口疼痛、感染、便秘等问题，进而能够直接影响伤口愈合及患者预后，给患者带来较大的痛苦，严重影响患者日常生活[3]。据资料显示，肛瘘术后便秘与患者切口疼痛、饮食、摄入水及负性情绪等因素有关，故在治疗过程中，必须辅以合理、有效的护理预防术后便秘[4]。……