Abstract：
OBJECTIVE: To compare the clinical effects of nonpressure and pressure dressings on the postoperative complications of modified Milligan-Morgan hemorrhoidectomy.
METHODS: Randomized controlled trial.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
METHODS: Randomized controlled trial.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
摘要：
目的：比较非压力和压力敷料对改良Milligan-Morgan痔切除术后并发症的临床效果。
方法：随机对照试验。
方法：纳入186例排除心脑血管疾病和肛肠手术的Ⅱ～Ⅲ级混合痔患者，按随机数字表法随机分为非压力敷料组和压力敷料组。急性尿潴留和医用粘合剂相关性皮肤损伤的发生率，疼痛,止血效果,肛门扩张,肛门水肿,使用镇痛药，住院时间,比较两组患者的住院费用。本研究使用随机对照试验的综合标准报告试验清单。
结果：非压力敷料组的男性和女性急性尿潴留的发生率均显着降低（相对风险[RR]=0.20，95％置信区间[CI][0.13，0.37]，P=.002）；（RR=0.47，95%CI[0.22，0.76]，P=.015）。无压力包扎组术后6小时/18小时/25小时疼痛明显低于对照组(P<.001,P=.004<0.05,P=.009)。无压力敷料组6小时的肛门扩张和使用镇痛药的患者数量明显减少（P<.001）。非压力敷料组的医用粘合剂相关皮肤损伤发生率明显较低(RR=0.061,95%CI[0.020,0.189],P<.001)。两组均未观察到原发性出血。然而,在肛门水肿评分方面，两组之间没有显着差异，逗留时间,或住院费用。在研究期间，两组均未报告不良事件。
结论：非压力敷料可有效降低Ⅲ～Ⅳ级混合痔术后急性尿潴留及医用粘连相关皮肤损伤的发生率。它们还可以安全地缓解疼痛和膨胀。
方法：随机对照试验。
方法：纳入186例排除心脑血管疾病和肛肠手术的Ⅱ～Ⅲ级混合痔患者，按随机数字表法随机分为非压力敷料组和压力敷料组。急性尿潴留和医用粘合剂相关性皮肤损伤的发生率，疼痛,止血效果,肛门扩张,肛门水肿,使用镇痛药，住院时间,比较两组患者的住院费用。本研究使用随机对照试验的综合标准报告试验清单。
结果：非压力敷料组的男性和女性急性尿潴留的发生率均显着降低（相对风险[RR]=0.20，95％置信区间[CI][0.13，0.37]，P=.002）；（RR=0.47，95%CI[0.22，0.76]，P=.015）。无压力包扎组术后6小时/18小时/25小时疼痛明显低于对照组(P<.001,P=.004<0.05,P=.009)。无压力敷料组6小时的肛门扩张和使用镇痛药的患者数量明显减少（P<.001）。非压力敷料组的医用粘合剂相关皮肤损伤发生率明显较低(RR=0.061,95%CI[0.020,0.189],P<.001)。两组均未观察到原发性出血。然而,在肛门水肿评分方面，两组之间没有显着差异，逗留时间,或住院费用。在研究期间，两组均未报告不良事件。
结论：非压力敷料可有效降低Ⅲ～Ⅳ级混合痔术后急性尿潴留及医用粘连相关皮肤损伤的发生率。它们还可以安全地缓解疼痛和膨胀。
