The Journal of Practical Medicine ›› 2022, Vol. 38 ›› Issue (23): 2988-2990.doi: 10.3969/j.issn.1006⁃5725.2022.23.017

• Clinical Research • Previous Articles     Next Articles

Efficacy of PPH in the treatment of circumferential prolapsed hemorrhoids and the influencing factors of postoperative urinary retention

SHAO Jihua,HUANG Ying,CHEN Fang.   

  1. The Second Department of Anorectal Medicine,Wuhan No.8 Hospital,Wuhan 430024,China

  • Online:2022-12-10 Published:2022-12-10
  • Contact: CHEN Fang E⁃mail:242946674@qq.com

Abstract:

Objective To investigate the efficacy of stapling procedure for prolapse and hemorrhoids (PPH)in the treatment of stage Ⅲ~Ⅳ circumferential prolapsed hemorrhoids and the influencing factors of postop⁃ erative urinary retention(UR). Methods From January 2018 to January 2019,a total of 120 patients with stage Ⅲ ~ Ⅳ circular prolapse hemorrhoids were enrolled in the Second Department of Anorectal Surgery,Wuhan Eighth Hospital and were randomly assigned to training set(= 90)and verification set(= 30). According to the occurrence of UR after operation,the training set was divided into UR group(= 26)and Non⁃UR group(= 64). The clinical data of the two groups were compared. Lasso⁃Logistic regression was used to screen the risk factors and establish a line chart model to validate it with a verification set. Results The total effective rate of PPH was 89.17%. The postoperative hematochezia score and the levels of serum β⁃EP,IL⁃17,IL⁃6,5⁃HT,CRP and TNF⁃α were significantly lower than those before operation. Multivariate analysis showed that age(OR = 1.118,= 0.006), intravenous infusion volume(OR = 1.780,= 0.007),postoperative SAS score(OR = 1.879,= 0.002),post⁃ operative analgesic pump(OR = 1.218,= 0.001)and postoperative 24hVAS score(OR = 1.547,= 0.003)were risk factors for UR. The risk value predicted by the line chart model is 0.93. The offline areas of training set and verification set ROC are 0.889 and 0.878 respectively. The predicted value of the calibration curve of the verifica⁃ tion set fits well with the actual value. Conclusion The clinical efficacy of PPH in the treatment of stage Ⅲ~Ⅳ circumferential prolapse hemorrhoids was better. Advanced age,large amount of intravenous fluid replacement, high postoperative SAS and VAS scores,and use of analgesic pump were the risk factors of UR. The working efficiency of the line diagram model was good.

Key words:

procedure for prolapse and hemorrhoids, circular prolapsed hemorrhoids, urinary reten? tion, Lasso regression model