仙方活命饮配合手术引流与外科手术治疗肛周脓肿的疗效比较

目的:比较手术引流配合仙方活命饮与单独手术治疗肛周脓肿的临床疗效。方法:选择2008年11月—2011年2月期间收治的肛周脓肿患者100例,随机平均分为研究组和对照组各50例。所有患者均于局麻/骶管麻醉下采取内口引流术。研究组治疗后给予仙方活命饮加减煎汤口服及坐浴;对照组每次便后用淡盐水洗净,且口服头孢丙烯分散片。结果:研究组治疗有效率明显优于对照组(P<0.05)。研究组的住院时间、创面愈合时间明显短于对照组(P<0.05);研究组的脓肿复发率、肛瘘发生率均明显低于对照组(P<0.05)。结论:手术引流配合仙方活命饮治疗肛周脓肿的临床疗效显著,且能够明显缩短创面愈合时间和住院时间,降低复发率及肛瘘发生率,值得临床广泛推广。     

痔瘘熏洗散用于痔术后消肿促愈疗效观察

为观察自制痔瘘熏洗散熏洗坐浴对痔术后肛缘水肿和创面愈合时间的影响,将200例痔术后患者随机分为两组治疗,治疗组100例术后每日便后采用痔瘘熏洗散熏洗坐浴;对照组100例术后每日便后采用1：5000PP液熏洗坐浴。观察记录两组患者术后肛缘水肿发生率和创面愈合时间,并进行统计学对比。结果显示,治疗组术后肛缘水肿发生率明显低于对照组（17％vs28％,P〈0．05）,创面愈合时间较对照组明显缩短[（13．8±3．8）dVS（16．5±4．5）d,P〈0．053。结果表明,痔瘘熏洗散用于痔术后熏洗坐浴能够有效降低肛周水肿的发生率,并能促进创面愈合。     

促愈汤联合消肿止痛方对环状混合痔术后恢复的影响

目的:探讨促愈汤内服联合消肿止痛方熏洗坐浴对环状混合痔术后恢复情况的影响。方法:选择2018 年1 月—2019 年10 月我院收治的行混合痔切除术的环状混合痔患者160 例,按照不同治疗方式分为常规治疗组(A 组)、促愈汤内服治疗组(B 组)、消肿止痛方熏洗坐浴治疗组(C 组)、促愈汤内服联合消肿止痛方熏洗坐浴治疗组(D 组),每组40 例。比较患者术后1 d、7 d 和14 d 时的VAS 疼痛评分、水肿评分和创面愈合情况。比较各组症状缓解时间、总体疗效、患者满意度和不良反应发生情况。结果:D组7d 时VAS 疼痛评分、水肿评分、创面面积、创面出血评分、渗液评分分别为(0.86±0.26)分、(0.80±0.53)分、(2.06±0.56) cm2、(0.64±0.25)分、(0.28±0.07)分,14 d 时分别为(0.14±0.08)分、(0.32±0.08)分、(0.68±0.28) cm2、(0.33±0.10)分、(0.17±0.04)分,疼痛缓解时间、水肿消退时间、出血停止时间分别为(3.12±1.53) d、(3.84 ±1.15) d、(2.03±0.97) d,无不良反应,上述指标均显著低于A、B、C 组;D 组总有效率和综合满意度分别为98% 和100%,均显著高于A、B、C 组,差异有统计学意义(P <0.05)。结论:促愈汤内服联合消肿止痛方熏洗坐浴治疗减轻患者术后疼痛、水肿效果更好,且能缩短症状缓解时间并减少术后并发症,获得患者更高的满意度。     

中药熏洗坐浴治疗痔术后并发肛门湿疹的疗效探讨

为探讨中药熏洗坐浴治疗痔术后并发肛门湿疹的疗效,将70例痔术后并发肛门湿疹的患者随机分为对照组和治疗组,各35例,对照组用1：5000高锰酸钾溶液熏洗坐浴,治疗组用中药液熏洗坐浴,观察两组治疗肛门湿疹的疗效,以及痔手术创口愈合时间、术后肛门疼痛和肛缘水肿消退时间。结果显示,治疗组治疗肛门湿疹的总有效率（91．4％）明显高于对照组（77．1％）,P〈O．05;痔手术创口愈合时间、术后肛门疼痛、肛缘水肿消退时间均明显短于对照组,P〈O．05。结果表明,中药熏洗坐浴治疗痔术后并发的肛门湿疹具有很好的疗效,而且能有效减轻痔术后患者的疼痛、水肿,促进创口愈合。     

连栀矾溶液联合龙珠软膏促进肛瘘术后创面愈合的临床效果观察

目的观察连栀矾溶液溻渍联合龙珠软膏纱条塞肛引流促进肛瘘术后创面愈合的临床效果。方法选择2016年3月至2017年2月在本院住院治疗的96例肛瘘患者,以随机数字表法分为对照组与治疗组,每组各48例。两组患者术后均予常规抗感染加换药治疗,治疗组患者在此基础上使用连栀矾溶液溻渍及龙珠软膏纱条引流14 d,2次/天,对照组患者使用龙珠软膏纱条引流相同时间。观察两组患者术后创面分泌物及水肿情况、创面疼痛程度及创面愈合率、痊愈时间。结果治疗组患者术后创面愈合率及愈合时间、术后创面疼痛评分、创面分泌物及水肿情况均优于对照组,差异均有统计学意义(均P0.05)。结论连栀矾溶液联合龙珠软膏外用可有效减轻肛瘘患者术后创面水肿、增加创面良性渗出、减轻患者创面疼痛及促进创面愈合,具有良好的临床效果。     

三黄解毒汤防治混合痔术后并发症250例

目的：评价三黄解毒汤熏蒸坐浴防治混合痔术后并发症疗效。方法：将500例混合痔术后患者随机分为两组,治疗组采用三黄解毒汤熏蒸坐浴,对照组采用高锰酸钾液熏洗坐浴。观察创面愈合及疼痛等术后并发症情况。结果：治疗组术后第24 h疼痛评分为（5.14±1.52）,对照组为（5.42±1.40）;治疗组第4 d创面水肿评分（1.08±0.35）,对照组为（1.32±0.43）;治疗组疼痛评分（2.45±0.21）,对照组为（3.77±0.31）;治疗组出血评分（1.49±0.56）,对照组为（1.62±0.45）,两组比较,差异有统计学意义（ P＜0.05）。结论：混合痔术后采用三黄解毒汤熏蒸坐浴,可减轻肛缘水肿,减少疼痛、减少出血。     

金马洗剂在肛肠病术后的应用

目的：观察金马洗剂治疗肛肠病术后疼痛、水肿及术创恢复延迟等并发症的疗效。方法：将298例肛肠病术后患者回顾性分为治疗组150例,对照组148例,治疗组以金马洗剂熏洗坐浴,对照组常规治疗,7 d为1疗程,两个疗程后判断疗效并进行统计分析。结果：治疗组第1及第2疗程总有效率分别为90.7%和96.7%,对照组则分别为76.3%和81.1%,治疗组总有效率明显优于对照组。治疗组患者的术后疼痛持续时间、水肿消退时间及创面愈合时间均早于对照组（P＜0.05）。结论：金马洗剂用于肛肠病术后熏洗坐浴,能明显减轻术后并发症。     

促愈外用方熏洗对热毒炽盛型肛周脓肿术后创面愈合的疗效

目的：观察促愈外用方熏洗对热毒炽盛型肛周脓肿术后创面愈合的临床疗效。方法：采用随机数字表法将90例肛周脓肿患者随机分为对照组和治疗组各45例。两组患者均行脓肿切开引流术（低位肛周脓肿行单纯脓肿切开引流术，高位肛周脓肿行脓肿切开置管引流术）。对照组术后予以高锰酸钾溶液熏洗坐浴，治疗组予以促愈外用方熏洗坐浴。分别检测两组患者术前及术后第3天的白细胞（WBC）、C反应蛋白（CRP）、中性粒细胞与淋巴细胞比率（NLR）；比较患者术后第1、7、14天肛门疼痛、创面渗出、肉芽组织评分；在术后第21天评价两组疗效，记录创面愈合时间及不良事件；随访1年，比较两组成瘘率。结果：治疗组的炎症指标（术后第3天）、肛门疼痛（术后第7、14天）、创面渗出（术后第14天）、肉芽组织情况（术后第7、14天）、临床疗效和创面愈合时间均优于对照组（P <0.05）。治疗组成瘘率有低于对照组的趋势，但差异无统计学意义（P> 0.05）。结论：促愈外用方熏洗坐浴可有效降低肛周脓肿的炎症指标，减轻术后肛门疼痛，减轻创面渗出，改善肉芽组织，缩短愈合时间，减少术后肛瘘形成，安全有效，值得临床推广。     

混合痔术后应用中药坐浴颗粒坐浴的疗效观察

为观察中药坐浴颗粒液坐浴对混合痔术后的临床疗效,将200例混合痔术后患者随机分为治疗组和对照组,每组各100例。手术方式为外剥内扎或PPH加外剥内扎术式,治疗组术后给予中药坐浴颗粒液熏洗坐浴,对照组术后给予1：5000PP液熏洗坐浴,观察1周内创面渗血、水肿、渗液及术后15d、20d、25d、30d复诊时创面愈合情况。结果显示,治疗组有效率为99％,对照组有效率为88％。治疗组创面的平均愈合时间为（18．9±5．0）d,对照组平均愈合时间为（23．8±5．0）d,治疗组优于对照组。结果表明,混合痔术后应用中药坐浴颗粒液坐浴疗效显著。     

消肿止痛汤熏洗坐浴用于肛瘘术后的疗效观察

目的：观察消肿止痛汤熏洗坐浴用于肛瘘术后的临床效果。方法：将72例肛瘘患者随机分为观察组和对照组,每组各36例。2组均采用肛瘘挂线术治疗,术后观察组采用消肿止痛汤熏洗坐浴,对照组采用康复新液熏洗坐浴。对比2组术后切口疼痛、肛缘皮肤水肿、切口肉芽组织生长情况以及愈合时间。结果：观察组切口愈合时间为（27.58±5.17）d,短于对照组的（34.44±4.91）d(P <0.05)。术后7d,观察组切口疼痛评分低于对照组（1.47±0.51）vs(2.22±0.54),差异有统计学意义（P <0.05）。术后14d,观察组切口肉芽组织生长评分高于对照组（3.67±1.12）vs(2.94±1.01),肛缘皮肤水肿评分低于对照组（1.17±1.00）vs(1.78±0.93),差异均有统计学意义（P <0.05）。结论：中药消肿止痛汤熏洗坐浴可显著减轻肛瘘术后切口疼痛和肛缘皮肤水肿,能促进切口肉芽组织生长,缩短切口愈合时间。     

新型湿性敷料在高位肛瘘术后创面中的应用

为探讨新型湿性敷料联合应用对促进高位肛瘘术后创面愈合的疗效,将35例高位肛瘘手术患者随机分为治疗组（新型湿性敷料）和对照组（传统方法）,进行创面愈合疗效的比较。结果显示,治疗组在减轻创面疼痛、渗出及创面愈合率方面均明显优于对照组（P〈0．01）。结果表明,新型湿性敷料联合应用在肛瘘术后的创面,能较好地控制局部感染,促进肉芽组织增生,加速上皮生长,并能缩短创面愈合时间,具有临床应用价值。     

三联疗法对混合痔术后肛门水肿、疼痛及创面愈合时间的影响

为观察三联疗法对混合痔术后肛门水肿、疼痛及创面愈合时间的影响,将126例拟行外剥内扎术的混合痔患者随机分为观察组和对照组,各63例。对照组患者术后常规换药,观察组患者术后在常规换药基础上,口服地奥司明片、静脉输注七叶皂苷钠、用复方角菜酸酯栓纳肛。对比观察两组患者术后肛门疼痛、水肿评分及创面愈合时间。结果显示,观察组患者术后第3人、第7天肛门疼痛、水肿评分均明显低于对照组,P〈0．05;创面愈合时间明显短于对照组,P〈0．05;用药6d,两组均末见明显不良反应。结果表明,三联疗法可有效减轻混合痔患者外剥内扎术后肛门疼痛及水肿程度,促进创面愈合。     

The associations between diode laser (810 nm) therapy and chronic wound healing and pain relief: Light into the chronic wound patient's life

Chronic wounds have become one of the major issues in medicine today, the treatments for which include dressing changes, negative pressure wound therapy, hyperbaric oxygen, light irradiation, surgery and so forth. Nevertheless, the application of diode lasers in chronic wounds has rarely been reported. This retrospective cohort study aimed to evaluate the therapeutic effect of diode laser (810 nm) irradiation on chronic wounds. Eighty-nine patients were enrolled in the study. The control group (41 patients) received traditional dressing change therapy, while the diode laser treatment group (48 patients) were patients received additional treatment with diode laser (810 nm) irradiation for 10 min at each dressing change. Wound healing time was compared between two groups, while the pain relief index was creatively introduced to evaluate the effect of relieving wound pain, which was calculated by the difference in pain scores between the first and last dressing changes divided by the number of treatment days. The wound healing time of the diode laser treatment group was 22.71 ± 8.99 days, which was significantly shorter than that of the control group (37.44 ± 23.42 days). The pain relief index of the diode laser treatment group was 0.081 ± 0.055, which was significantly increased compared with that of the control group (0.057 ± 0.033). Our findings suggest that diode laser irradiation has the potential to promote healing in chronic wounds and relieve wound pain.     

肛愈散熏洗治疗混合痔术后并发症的临床疗效观察

目的观察肛愈散熏洗治疗混合痔术后并发症的临床疗效。方法将符合纳入观察标准的180例混合痔患者随机分为3组,每组60例,治疗组采用肛愈散剂熏洗,对照1组采用肛愈散煎剂熏洗,对照2组采用痔疾洗液熏洗。3组均以10d为1个疗程,观察3组术后疼痛、水肿、便血、肛门坠胀等临床指标评分,及止痛起效时间、创面愈合时间等。结果各组比较,术后疼痛持续时间,创面愈合时间,水肿、便血、肛门坠胀等方面存在显著差异,治疗组疗效明显优于各对照组（P〈0.01）。结论肛愈散能有效治疗混合痔术后疼痛、便血、肛门坠胀、水肿等并发症,且止痛起效时间短,能有效促进混合痔术后康复。     

Analysis of curative effect of insulin external application on burn wounds of diabetic patients with different depths

To explore the curative effect of insulin external application on burn wounds of diabetic patients with different depths. A retrospective analysis of 114 diabetic burn patients in the First Hospital of Hebei Medical University from June 2019 to June 2022. According to the different treatment methods, they were divided into study group (insulin therapy) and control group (conventional therapy) with 57 cases in each. The wound healing time, dressing changes, scar healing after wound healing and adverse events were compared between two groups. Pain level, serum inflammatory factors, vascular endothelial growth factor (VEGF) and oxidative stress factors before and after treatment were compared. The wound healing time (17.23 ± 2.18 vs 20.31 ± 2.09 days) and the number of dressing changes (7.01 ± 1.23 vs 8.93 ± 1.32 times) in study group were significantly lower than those in control group (P < 0.05). Before treatment, there was no difference in pain level, VEGF, interleukin-1 (IL-1), tumour necrosis factor-α (TNF-α), malondialdehyde (MDA) and superoxide dismutase (SOD) between two groups (P > 0.05). However, the pain level, scar healing, IL-1, TNF-a and MDA in study group were significantly lower than those in control group after treatment (P < 0.05). And the VEGF and SOD in study group was significantly higher than that in control group (P < 0.05). External application of insulin can shorten the wound healing time of diabetic patients with different depths, reduce the number of dressing changes, promote scar healing after wound healing, relieve pain and reduce the level of inflammatory factors, which is worthy of clinical promotion.     

中药内服外敷促进肛瘘电凝术后创面愈合的疗效观察

为提高促进肛瘘术后创面愈合的疗效,将60例高位肛瘘电凝术后患者随机分为治疗组和对照组,每组30例。治疗组采用中药内外合治,内治针对不同病期辨证施治,采用不同方剂治疗;外治采用三黄膏纱条和紫银膏纱条引流治疗。对照组采用湿润烧伤膏纱条换药引流治疗。结果显示,两组疗效相近,但在临床症状改善程度、住院时间与治疗费用方面治疗组明显优于对照组。结果表明,针对肛瘘电凝术后不同时期病情变化,辨证论治采用中药内服、外敷,愈合时间短,经济有效,患者易于接受。     

An open multicenter comparative randomized clinical study on chitosan

Chitosan, a natural polysaccharide derivate from chitin, offers a promising alternative biomaterial for use in wound dressings. In this work, the safety and efficacy of a next‐generation KA01 chitosan wound dressing in facilitating the healing of nonhealing chronic wounds was studied. This open multicenter comparative prospective randomized clinical study was conducted at three medical centers in China. A total of 90 patients (45 in test group and 45 in control group) with unhealed chronic wounds including pressure ulcers, vascular ulcers, diabetic foot ulcers, and wounds with minor infections, or at risk of infection, were treated with the next generation chitosan wound dressing as the test article or traditional vaseline gauze as a control. Baseline assessments were undertaken with the primary end point being wound area reduction. The secondary end points included pain reduction (using the NRS11 pain scale) at dressing change, wound exudate levels, wound depth and duration of the treatment. After 4 weeks treatment, the wound area reduction was significantly greater in the test group (65.97 ± 4.48%) than the control group (39.95 ± 4.48%). The average pain level in the test group was 1.12 ± 0.23 and 2.30 ± 0.23 in the control group. The wound depth was also lower in the test group 0.30 ± 0.48 cm than the control group 0.54 ± 0.86 cm. The level of exudate fell and the dressing could be removed integrally in both the test and control groups. The mean duration of the test group was 27.31 ± 5.37 days and control group 27.09 ± 6.44 days. No adverse events were reported in either group. In conclusion this open multicenter comparative prospective randomized clinical study has provided compelling evidence that the next generation chitosan wound dressing can enhance wound progression towards healing by facilitating wound reepithelialization and reducing the patients pain level. Furthermore the dressing was shown to be clinically safe and effective in the management of chronic wounds.     

黏膜下移袋形缝合术治疗低位肛瘘

目的:探讨比较肛瘘切除加黏膜下移袋形缝合术与单纯肛瘘切除术治疗低位肛瘘的临床疗效。方法:将42例患者按随机数字表法分为治疗组(肛瘘切除加黏膜下移袋形缝合术)和对照组(单纯肛瘘切除术),各21例。观察比较两组术后创面愈合时间、术后疼痛评分、术后水肿发生率、术后出血情况、术后疤痕面积和术后肛门功能的情况。结果:两组在术后疼痛、水肿及术后肛门功能方面无显著差异(P0.05),但是治疗组术后创面愈合时间为(21.30±1.55)d,明显优于对照组的(28.48±2.35)d,差异具有统计学意义(P0.05);术后出血情况治疗组亦少于对照组(P0.05);治疗组术后疤痕面积为(34.5±9.62)mm~2,对照组术后疤痕面积为(68.9±10.83)mm~2,两组比较存在显著性差异(P0.05)。结论:黏膜下移袋形缝合术应用于低位肛瘘中不但能够更好地保护肛门功能,减少术后出血的发生率,而且能够进一步降低肛管缺损的发生率,减小术后疤痕形成,缩短创面愈合的时间。     

三黄痔疮膏对混合痔术后创面愈合的临床疗效

目的:观察三黄痔疮膏对混合痔术后创面愈合的临床疗效.方法:选取2018年3月—2020年3月在我院肛肠科住院的行混合痔外剥内扎术的住院患者共80例,随机分治疗组和对照组各40例,两组均给予行外剥内扎术,术后予中药激光坐浴机熏洗坐浴,对照组给予坐浴后凡士林纱条换药引流,治疗组给予自制三黄痔疮膏油纱换药引流,观察术后第1、...     

A prospective,randomized trial of silver containing hydrofiber dressing versus 1% silver sulfadiazine for the treatment of partial thickness burns

Silver sulfadiazine has been used as a topical burn wound treatment for many years. Pain associated with dressing changes is a common problem in burn wounds. Aquacel Ag, a hydrofiber dressing coated with ionic silver has been reported to reduce burn wound infection and promote antimicrobial activity. The purpose of this study was to show the benefits of Aquacel Ag for the treatment of partial thickness burns. This prospective randomized study was conducted in 70 patients who had partial thickness burns less than 15% of total body surface area and were treated at Siriraj outpatient burn clinic during December 2006–February 2008. Patients were divided into two groups: Aquacel Ag‐treated group with dressing changes every 3 days (35 patients) and 1% silver sulfadiazine‐treated group, with daily dressing changes (35 patients). There was no difference in demographic data including age, gender, burn percentage between groups. Time‐to‐wound healing pain score during dressing change and cost of treatment were compared between both groups. Time‐to‐wound closure was significantly shorter in the Aquacel Ag‐treated group (10 ± 3 versus 13.7 ± 4 days, P < 0·02) as well as pain scores at days 1, 3 and 7 (4·1 ± 2·1, 2·1 ± 1·8, 0·9 ± 1·4 versus 6·1 ± 2·3, 5·2 ± 2·1, 3·3 ± 1·9, respectively, P < 0·02). Total cost of treatment was 52 ± 29 US dollars for the Aquacel Ag‐treated group versus 93 ± 36 US dollars for the silver sulfadiazine‐treated group. This study showed that Aquacel Ag increased time to healing, decreased pain symptoms and increased patient convenience because of limiting the frequency of replacement of the dressing at lower total cost. This study confirms the efficacy of Aquacel Ag for the treatment of partial thickness burns at an outpatient clinic.