金标准却不显眼--孟加拉国一家外围免费医院的传统痔疮手术经验。

Mymensingh medical journal : MMJ Pub Date : 2024-07-01
H R Sazal, S Hasan
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引用次数: 0

摘要

在欠发达国家的一家外围医院,社会经济地位较低的病人无法获得痔疮手术治疗的最新进展。这项描述性、前瞻性、观察性研究从痔疮确诊到手术治疗,并在术后随访 12 个月。研究了临床病理数据以及随访期间的并发症和复发情况。本研究共纳入 64 名成年患者,平均年龄为 38.6 岁,男女比例为 1.7:1。症状的平均持续时间为 13 个月,反映出患者发病较晚。36(56.3%)例患者的痔块多为两个,44(68.8%)例患者的痔块仅位于肛管的原发部位(3、7 和 11 点钟方向),但 18(28.1%)例患者的痔块位于原发和继发的混合位置。同样,在有一个以上痔疮的患者中,4 级痔疮最常见,有 35 人(53.1%),其次是 15 人(23.4%)只有 3 级痔疮,但有 10 人(15.6%)有 3 级和 4 级混合痔疮。56例(87.5%)患者的恢复过程中并发症较少,其中2例(3.6%)患者报告伤口愈合延迟和疼痛,其次是1例(1.6%)患者报告尿潴留、肛门败血症、原发性出血和反应性出血。平均住院时间为 4 天。在任何情况下,传统手术都是治疗可手术痔疮的有效且经济的选择。
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Gold Standard yet Inconspicuous- Our Experience of Conventional Haemorrhoid Surgeries in a Peripheral Free of Cost Hospital of Bangladesh.

Recent advancement in surgical treatment of haemorrhoidal disease is not accessible by low socio-economic group of patient in a peripheral hospital of an underdeveloped country, where we aimed to evaluate the outcome of conventional surgeries. This descriptive, prospective, observational study was performed from diagnosis of haemorrhoidal disease to surgical intervention and followed up 12 months post operatively. Clinico-pathological data and outcome in the form of complications and recurrence within follow-up period was studied. Total 64 adult patients with mean age 38.6 years and male female ratio 1.7:1 were included in this study. Mean duration of symptoms was 13 months, reflects late presentation. Two (2) piles mass was seen most frequent in 36(56.3%) cases and most of the patients i.e. 44(68.8%) had haemorrhoids only on primary sites (3, 7 and 11 o'clock) of anal canal, but 18(28.1%) had mixed primary and secondary position of haemorrhoids. Similarly among those who had more than one haemorrhoid, grade 4 was commonest 35(53.1%) followed by only grade 3 in 15(23.4%) cases but mixed grade 3 and 4 was seen in 10(15.6%) patient. Complication less recovery was seen in 56(87.5%) cases, where delayed wound healing and pain was reported in 2(3.6%) patient each, followed by 1(1.6%) each reported urinary retention, anal sepsis, primary bleeding and reactionary bleeding. Mean hospital stay was 4 days. Conventional surgeries are equally efficacious and cost effective option for management of operable haemorrhoidal disease at any setup.

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