郭建军 凌应飞 李强

[關键词] 复方角菜酸酯;痔切除术;排便功能;止痛效果

[中图分类号] R623.2          [文献标识码] A          [文章编号] 1673-9701（2021）19-0034-04

Study on the effect and mechanism of different compound carrageenate preparations on postoperative defecation and analgesic effect in elderly patients undergoing hemorrhoidectomy

GUO Jianjun   LING Yingfei   LI Qiang

Department of Anorectal， Meishan Traditional Chinese Medicine Hospital in Sichuan Province， Meishan   620000， China

[Abstract] Objective To explore the effect and possible mechanism of different compound carrageenate preparations on defecation and analgesic effect in elderly patients undergoing hemorrhoidectomy. Methods A total of 90 elderly patients undergoing hemorrhoidectomy in our hospital from May 2016 to May 2018 were enrolled as research subjects. The patients were divided into groups A， B and C by random number table method， with 30 cases in each group. Group A was given routine treatment after surgery， group B was given compound carrageenate cream after surgery， and group C was given compound carrageenate suppository after surgery. The postoperative visual analogue pain score （VAS） and wound healing time were compared between the three groups of patients. The patients′ anal resting pressure （ARP）， maximum systolic pressure （MASP） and rectal resting pressure （RRP） were recorded before and after the intervention. The occurrence of fine bowel dysfunction after the operation was compared between the two groups. The wound granulation tissue was taken before and after the intervention， and the positive expression rate of interleukin-8 （IL-8）， metal matrix proteinase 9 （MMP-9）， and inducible nitric oxide synthase （iNOS） in the wound granulation tissue was detected by the immunohistochemical method. Results The VAS scores of the three groups at the preoperative 3 d and at discharge after surgery were lower than those before the operation， and the difference was statistically significant（P<0.05）. The VAS scores of the patients in group B were significantly lower than those of group A and group C at three days after surgery and wound healing time， and the differences were statistically significant（P<0.05）. The ARP and MASP of the patients in group A on the day after the operation and at discharge were significantly lower than those before the operation， and the RRP was significantly higher than that before the operation， and the difference was statistically significant （P<0.05）. There was no significant difference in ARP， MASP， and RRP at discharge from before operation（P>0.05）. The incidence of postoperative fine defecation dysfunction in groups B and C was significantly lower than that in group A， and the difference was statistically significant（P<0.05）. The positive rates of IL-8， MMP-9， and iNOS in group B and group C were significantly lower than those in group A at discharge， and the differences were statistically significant（P<0.05）. Conclusion The use of compound carrageenate in elderly patients undergoing hemorrhoidectomy can help promote the recovery of postoperative wounds and bowel function， which is related to its inhibition of IL-8， MMP-9 and iNOS， and cream preparations have better analgesic effects than suppositories.