| Surgical operation is the most important means for the treatment of hemorrhoids. In recent years surgical treatment concepts and technologies have considerable progress, the major progress of hemorrhoids surgical treatment is minimally invasive and minimally pain techniques popularization. Electro-chemical therapy by cupric ion(ECICI),as an atrophic hemorrhoids, no continuous wound, fast healing, operation of the painless area, have more widely used in the surgical operation of hemorrhoids patients.Objective:1. To verify the therapy, postoperative complications and safety of the treatment of mixed hemorrhoids by ECTCI cooperate with external hemorrhoids, comparing with the PPH cooperate with external hemorrhoids.2. To check the attachments on the surface of copper needle, the changes about H2O2and ions on hemorrhoid area in pre-therapy and post-therapy, and to analyze the principle of ECTCI for hemorrhoids.Method:1. Clinical study(1)Randomly divide320cases hemorrhoids (for â…¡, â…¢, and IV degrees) patients into two groups, one group for the ECTCI group and the other for PPH group.(2)Treatment means:ECTCI group (160cases hemorrhoids) using ECTCI combined with external hemorrhoids resection and PPH group (160cases hemorrhoids) using PPH operation combined with external hemorrhoids resection.(3)Observation:In different days, such as the first/third day/the first week/the first/third/sixth month after the operations, record the observed indexes, including bleeding, emergence, anal pain, anal edema, and anal stenosis, and also analyze the efficiency, postoperative complications, recovery time and the expenses.(4)efficacy criteria:All curative effect is divided into four grades.(5) Evaluation method of safety:At the same time, check the changes about the routine blood count and Urine, liver and kidney functions, and the ECG, and then analyze the safety of PPH and ECTCI.(6)statistical method: statistical analysis was done by SPSS19.0, P<0.05with statistical significance.2. Experimental studyScrape the attachments from the positive and negative electrode surface for the infrared detection, EDS quantitative analysis, and find the changes of elements, ingredients, the concentration of H2O2and ions. Then deduce the ECTCI mechanism.Result:1. Clinical study(1) Curative effect:There was no obvious difference on curative effect between ECTCI group and PPH group(P>0.05).(2) Postoperative complications:ECTCI group postoperative anal pain score and anal straining two indicators in each visit was significantly lower than that in PPH group, with significant difference (P<0.05); ECTCI group3days after operation of anal edema compared with the PPH group with significant difference (P<0.05), the rest of the time have no significant difference (P>0.05); ECTCI group after24hours urination disorder degree I and II compared with the PPH group with significant difference (P<0.05); was significantly lower than that of PPH group in January, internal bleeding after operation in ECTCI group, the two groups had significant difference (P<0.05), after March June, no two group significant differences (P>0.05); ECTCI group after January anal stenosis rate was significantly lower than that in PPH group (P<0.05), the rest of the viewpoint is no significant difference between two groups (P>0.05).(3) Safety evaluation:ECTCI group in the preoperative and postoperative blood routine, urine routine and liver and kidney function, there was no significant difference between ECG changes (P>0.05); the two group of safety grade evaluation of ECTCI than in PPH treatment hemorrhoids security (P<0.05).(4)others:Compared with the PPH, hospital costs and restore the normal life is less in ECTCI group (P<0.05).2. experimental studyInfrared spectrum detection results:copper needle plus or minus two electrode attachments to the same characteristic peaks; EDS quantitative detection results: attachment contains more of C, O, Cl, Cu copper surface element. Hemorrhoids H2O2concentration in blood and the content of Cu2+increased obviously after treatment than before treatment (P<0.05), with a significant difference before and after treatment, Cl" and Fe2+had no significant difference (P>0.05).Conclusion:1.Clinical study(1Effectiveness and safety:The ECTCI group has the same efficacy as PPH group, and it is also safe. The ECTCI can decrease the complications, improve the quality of life for patients, and also cut the medical expenses.(2)Complications:All patients underwent external hemorrhoidectomy, postoperative anal pain scores not directly reaction caused by two kinds of operation but because the sample size is large, decrease in both sides of the equation the same premise, reflecting the degree of pain can represent the degree of pain ECTCI and PPH the two patients after operation. PPH postoperative anal anastomosis nail comes off the residual, cause anal persistent tingling and intraoperative traction pain is a major cause of PPH higher pain scores than ECTCI; anastomotic nail off across the bleeding caused by vascular anastomosis or too low, the purse-string suture nail not completely need to suture hemostasis and cause anal stenosis, because the formation of PPH circumferential wound, and hemorrhoids area rich in blood vessels, bleeding may be needed to avoid postoperative, anal pressure hemostasis, increase the postoperative anal edema are PPH surgical complications caused by itself.(3)Cost and healing time:two methods of medical cost difference is the main reason leading to hospitalization cost difference, in addition PPH postoperative complications, symptomatic treatment further increased the cost of hospitalization. PPH is the circumferential incision, and the surgery left staple healing effect, no ECTCI continuous wound, resulting in two kinds of surgical postoperative healing time difference.2. Experimental study:(1)Infrared spectroscopy results:Infrared spectrum characteristic peaks of chloroform soluble anode and cathode of the same material, presumably for the same. Infrared spectrum characteristic peaks of positive and negative poles attached to the same, that the main component of two white matter; white matter anode attachment in chloroform insoluble infrared spectrum of IR spectra and cellulose material is similar to the white matter, infrared spectrum and infrared spectrum and soluble anode attachment are similar, the sample contains other substances except white material principal component. EDS quantitative conclusions:positive and negative two electrode attachment by two types of material, a class of organic compounds, such as inorganic, CuCl2probability.(2)H2O2is the intermediate product of ECTCIDuring the ECTCI treatment, H2O2concentrations increased significantly. May be locally produced a large number of oxygen (visible bubble overflow treatment), intermediate product of oxidative metabolism, H2O2in the body can be transformed into OH, the local will cause the stimulation of endothelial cells, is caused by the material basis of vascular endothelial cell injury.(3)Cu2+is an important material in the ECTCIDuring the ECTCI treatment, the copper is to generate a large number of copper ion electricity, the formation of large molecular complexes; and the copper and two kinds of protein binding, one of them is SOD. we hypothesized that during ECTCI treatment, Cu2+binding the surrounding SOD, and decreased the activity of SOD, also exacerbated inflammatory vascular endothelial cell reaction, so that local thrombosis and vascular obstruction and reach the purpose of hemostasis. |
PDF Full Text Request