Division of Surgery, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Division of Surgery, Institute of Integrated Traditional Chinese and Western Medicine, Chengdu Shang Jin Nan Fu Hospital of West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Division of Surgery, Institute of Integrated Traditional Chinese and Western Medicine, Chengdu Shang Jin Nan Fu Hospital of West China Hospital of Sichuan University, Chengdu, Sichuan, China.
J Perianesth Nurs. 2024 Dec;39(6):1088-1094. doi: 10.1016/j.jopan.2024.02.006. Epub 2024 Jun 12.
To compare the clinical effects of nonpressure and pressure dressings on the postoperative complications of modified Milligan-Morgan hemorrhoidectomy.
Randomized controlled trial.
A total of 186 patients with grade II to III mixed hemorrhoids who had been excluded from cardiovascular and cerebrovascular diseases and anorectal surgery were included and randomly assigned to the nonpressure dressings group and the pressure dressings group by random number table. The incidence of acute urinary retention and medical adhesive-related skin injury, pain, hemostatic effect, anal distension, anal edema, use of analgesics, length of hospital stay, and hospitalization costs were compared between the two groups. The Consolidated Standards of Reporting Trials checklist for randomized controlled trials was used in this study.
The incidence of acute urinary retention in both men and women was significantly lower in the nonpressure dressing group (relative risk [RR] = 0.20, 95% confidence interval [CI] [0.13, 0.37], P = .002); (RR = 0.47, 95% CI [0.22, 0.76], P = .015). The postoperative pain at 6 hours/18 hours/25 hours was significantly lower in the nonpressure dressing group (P < .001, P = .004 < 0.05, P = .009). The anal distension at 6 hours and the number of patients who used analgesics were significantly lower in the nonpressure dressing group (P < .001). The incidence of medical adhesive-related skin injuries was significantly lower in the nonpressure dressing group (RR = 0.061, 95% CI [0.020, 0.189], P < .001). No primary bleeding was observed in both groups. However, there were no significant differences between both groups in terms of anal edema scores, length of stay, or hospitalization expenses. No adverse events were reported in either group during the study period.
Nonpressure dressings can effectively reduce the incidence of acute urinary retention and medical adhesion-related skin injury after surgery for grade III to IV mixed hemorrhoids. They can also safely relieve pain and distension.
比较非压力和压力敷料对改良的 Milligan-Morgan 痔切除术术后并发症的临床效果。
随机对照试验。
纳入了 186 例排除心血管和脑血管疾病及肛肠手术的 II 至 III 度混合痔患者，按随机数字表法分为非压力敷料组和压力敷料组。比较两组患者急性尿潴留、医用胶相关皮肤损伤、疼痛、止血效果、肛门肿胀、肛门水肿、镇痛药使用、住院时间、住院费用的发生率。本研究采用 CONSORT 随机对照试验报告规范清单。
非压力敷料组男性和女性的急性尿潴留发生率均明显低于压力敷料组（相对风险[RR] = 0.20，95%置信区间[CI] [0.13，0.37]，P = 0.002）；（RR = 0.47，95% CI [0.22，0.76]，P = 0.015）。非压力敷料组术后 6 小时/18 小时/25 小时的疼痛明显低于压力敷料组（P < 0.001，P = 0.004 < 0.05，P = 0.009）。非压力敷料组在术后 6 小时肛门肿胀和使用镇痛药的患者人数明显减少（P < 0.001）。非压力敷料组医用胶相关皮肤损伤发生率明显低于压力敷料组（RR = 0.061，95% CI [0.020，0.189]，P < 0.001）。两组均未发生原发性出血。然而，两组在肛门水肿评分、住院时间或住院费用方面无显著差异。研究期间，两组均未报告不良事件。
非压力敷料可有效降低 III 至 IV 度混合痔术后急性尿潴留和医用胶相关皮肤损伤的发生率，还能安全缓解疼痛和肿胀。
