目的 分析20 年来研究的热点问题和其发展历程,总结概括其发展状况并对该领域未来的发展进行一定预测.方法 以Web of Science和中国知网上2001 年至2020 年这20 年世界各地发表的与湿疹的基因组学相关的文献为基础,对这些文章进行更深一步的归类、整理.选择使用针对文献的分析软件Citespace对20 年来Web of Science核心合集数据库发表的与湿疹基因组学相关的文献的发文国家、发文机构、发文作者、纳文期刊、文献共被词等数项领域进行数据统计以及可视化建模,以可视化图片和数据表格的形式记录各项要点并对结果进行整合分析.结果 通过筛选,本次研究共纳入529 篇与湿疹基因组学相关的文献.该种文献每年的发文量总体上呈现波动上升的趋势.其20 年来的研究热点主要集中在发现新的易感基因和风险位点上,并且正处于不断完善的过程中,目前湿疹基因组学的研究主要向着在基因组不断健全的基础上找到致病因素,治疗和预防疾病上靠拢.结论 虽然经历了20 多年的发展,但湿疹基因组学的研究仍有许多新的内容与研究方向尚待开发.该研究对目前湿疹基因组学的发展状况做出总结,对后续的研究也起到一定的指导作用.

Objective:To explore the effects of multidimensional pain intervention model on postoperative pain in patients with perianal abscess.Methods:Totally 106 patients with perianal abscess who were admitted to the China-Japan Friendship Hospital from March 2020 to March 2022 were selected by convenience sampling and divided into observation group and routine group according to the admission time, with 53 patients in each group. Patients in the routine group received routine nursing care, while patients in the observation group were treated with a multidimensional pain intervention model based on the care provided to the routine group. The postoperative Numerical Rating Scale (NRS) and Depression-Anxiety-Stress Scale 21 (DASS-21) scores were compared between the two groups.Results:The NRS scores of the observation group at 1, 3, 5 and 7 days after surgery were all lower than those of the routine group, and the differences were statistically significant ( P<0.05) ; the DASS-21 scores of the observation group were lower than those of the routine group at 1 and 7 days after surgery, with statistically significant differences ( P<0.05) . Conclusions:The multidimensional pain intervention model can ameliorate postoperative pain and negative emotions of patients with perianal abscess.

目的:观察减创肛瘘根治术治疗婴幼儿低位肛瘘的安全性及临床疗效.方法:将100例小儿低位肛瘘患者,分为治疗组和对照组,每组50例.治疗组行减创肛瘘根治术,对照组采用莫匹罗星软膏外涂治疗.均随访6个月以上,观察比较治疗后2组患儿的肛门疼痛情况、创面愈合时间、Wexner肛门功能评分及临床疗效.结果:2组患儿治疗后第1d疼痛程度差异无统计学意义(P＞0.05),治疗组在治疗后第2d、3d疼痛评分高于对照组,第7d、14d、21d疼痛评分低于对照,差异均有统计学意义(P＜0.01).治疗组创面愈合时间低于对照组,临床疗效显著优于对照组,差异均有统计学意义(P＜0.01).治疗后3周、6个月时肛门失禁Wexner评分治疗组均优于对照组,差异均有统计学意义(P＜0.01).结论:减创肛瘘根治术治疗婴幼儿低位肛瘘安全性好、疗效显著,同时可较好保护患儿肛门功能.

目的:探讨婴幼儿肛周脓肿及肛瘘的手术时机、治疗方式的选择以及创面的护理.方法:从发病原因、治则治法、诊疗实践、术后护理几方面总结了小儿肛周脓肿、肛瘘的治疗成功经验.结果:在初起局部红肿、未成脓时期,可先行保守治疗观察;在脓肿形成期,视病情行切开排脓术,如内口明确,行肛周脓肿一次性根治术;形成肛瘘后需判断活动期还是静止期,应避免过度治疗.婴幼儿肛瘘多数瘘管较表浅,肛瘘切开术是最常用且损伤最小的术式,术中需仔细探查有无其他瘘管分支,可视病情行挂线治疗.结论:在婴幼儿肛周脓肿及肛瘘的诊治中,需根据患儿具体情况和疾病特点来权衡利弊,治疗要遵循分期论治的原则.肛周局部应避免热敷及理疗,术后保持创面清洁干燥.

功能性肛门直肠痛是一种以肛门直肠疼痛、坠胀、便意明显为主要临床表现的肛门直肠疾病,具有病程长、易反复特点,尤其慢性功能性肛门直肠痛患者生活质量下降明显,常合并失眠、抑郁、焦虑等.目前单纯西药治疗效果不佳.中医有一定疗效,但仍有部分患者疗效不佳.本文提出"气滞血瘀"是功能性肛门直肠痛核心病机,"从瘀论治"是其基本治法,并取得较好的临床效果.

目的:基于网络药理学方法初步探讨肛肠瘙痒洗剂治疗肛周湿疹的机制.方法:应用TCMSP数据库,根据DL≥0.18,ALogP<0.5对成分信息进行筛选后,检索药物相关靶点,共获得药物靶点258个.在GeneCards数据库中查找"湿疹"疾病相关基因,共获得相关基因2736个.药物和疾病共有靶点114个.使用String数据库获得蛋白-蛋白相互作用(PPI)关系,用Cytoscape软件进行可视化.根据蛋白相互作用的"degree"值,获得关键作用靶点,采用R软件中的"Bioconductor"安装包对靶点进行GO及KEGG通路分析.结果:网络分析结果表明,肛肠瘙痒洗剂主要通过细胞因子及受体诱导免疫激活,可能通过调节IL-17信号通路、TNF信号通路、Toll样受体信号通路、Th1及Th2细胞分化、JAK-STAT信号通路、Th17细胞分化等信号通路来发挥其治疗作用.结论:本研究综合应用网络药理学的方法预测出肛肠瘙痒洗剂治疗湿疹的作用机制和分子靶点,为其进一步实验研究鉴定基础.

目的:探讨不同封闭术治疗慢性肛周湿疹临床疗效及机制.方法:80例肛周湿疹患者,随机分为治疗组和对照组,每组40例.治疗组采用游离皮下组织+亚甲蓝封闭治疗,对照组采用曲安奈德注射液+亚甲蓝封闭治疗.观察两组患者治疗后1、3个月的临床疗效、肛周皮损面积和瘙痒评分,并统计治疗后6个月复发情况.结果:治疗组较对照组治疗慢性肛周湿疹总有效率具有明显优势(P＜0.05).两组经不同封闭术治疗后1、3个月的瘙痒评分和皮损面积评分对比,治疗组较对照组能有效缓解肛门瘙痒并恢复皮损面积(P＜0.05).结论:治疗组较对照组能明显改善慢性肛周湿疹症状,且创伤小,恢复快,复发低,值得推广使用.

胶圈套扎术和注射疗法是目前临床治疗痔病的常用方法.因其具有临床疗效确切、术后创面小、术后并发症少、愈合时间短的优势,在临床得到较为广泛的应用.虽然此两种治疗方式的临床疗效总体令人满意,但尚缺乏统一规范的手术与操作标准,同时也有待制定统一严谨的科研评价方案以及临床疗效评估标准,多方面的共同努力将对进一步提升临床诊疗质量具有重要的意义.

目的 比较横分纵扎术与外剥内扎术治疗内痔为Ⅲ～Ⅳ度的环状痔疗效及安全性.方法 将2019年3月至2019年9月在中日友好医院肛肠科住院的60例环状痔(内痔为Ⅲ～Ⅳ度)患者随机分为治疗组与对照组,每组各30例.治疗组采取横分纵扎术,对照组采用外剥内扎术.比较两组的疗效及安全性.结果 两组的总有效率均为100％,治愈率比较差异无统计学意义(P>0.05).切口愈合时间比较差异无统计学意义(P>0.05).术后第30天,治疗组术后残余外痔覆盖点位数少于对照组(P<0.05).术后第1天,两组VAS评分比较差异无统计学意义(P>0.05),术后第3、7天,治疗组VAS评分均低于对照组(均P<0.05).两组均未出现较大量的出血事件,尿潴留及肛门狭窄发生率比较差异均无统计学意义(均P>0.05),治疗组创缘水肿发生率低于对照组(P<0.05).结论 横分纵扎术治疗内痔为Ⅲ～Ⅳ度的环状痔疗效确切,安全性良好,在减轻术后疼痛、创缘水肿及减少外痔残留方面相比外剥内扎术有一定的应用优势.

说起肛周病,我们想到的恐怕就是痔疮.这肛周炎性疾病是怎么回事?怎么会有如此杀伤力? 肛周炎性疾病有急慢性之别.急性炎性疾病除上面说到的坏死性筋膜炎、肛周脓肿,还有肛瘘、化脓性大汗腺炎、藏毛囊肿、表皮样囊肿、骶尾部畸胎瘤等.这些疾病虽然没有痔疮发病率高,但其痛苦程度和危害性都远超过痔疮.

目的:比较横分纵扎术是否配合套扎器治疗对重度痔的临床疗效.方法:将160例具备手术指征符合重度痔诊断的患者按数字表法1:1随机分成观察组及对照组.观察组采用横分纵扎术配合套扎器治疗;对照组采用横分纵扎术.观察比较2组的手术时间、术后评分疼痛、肛缘水肿、出血、愈合时间.结果:观察组的手术时间、疼痛、术后出血、愈合时间优于对照组(P＜0.05).结论:横分纵扎术配合套扎器治疗重度痔有良好的临床效果,可缩短手术时间,降低手术难度、减轻术后疼痛,减少出血、缩短创面愈合时间,值得临床推广.

目的 分析痔疮手术患者采用集束化护理的临床效果.方法 80例痔疮手术患者,随机分为对照组与试验组,每组40例.对照组患者采用常规院内护理,试验组患者在对照组基础上采用集束化护理,比较两组患者术后住院时间、临床效果及护理满意度.结果 试验组患者术后住院时间短于对照组,差异具有统计学意义(P<0.05).试验组患者总有效率为95.0％,高于对照组的75.0％,差异具有统计学意义(P<0.05).试验组患者护理满意度为92.5％,高于对照组的72.5％,差异具有统计学意义(P<0.05).结论 对痔疮手术患者应用集束化护理,可有效提高患者护理满意度,促进患者早日恢复健康.

目的:观察肛肠瘙痒洗剂治疗肛周湿疹的临床疗效.方法:120例肛周湿疹患者,按随机数字表法分为治疗组和对照组,每组60例.治疗组使用中日友好医院院内制剂——肛肠瘙痒洗剂坐浴治疗,对照组患者采用曲安奈德益康唑乳膏外涂治疗.观察2组患者治疗前、治疗后1个月、3个月的瘙痒评分,统计痊愈率、有效率,治疗后6个月随访复发情况.结果:2组患者治疗前瘙痒评分及治疗后有效率均无显著性差异(均P＞0.05).治疗组治疗后1个月及3个月的瘙痒评分均显著低于对照组(均P＜0.05),治疗组痊愈率(80.0％)显著高于对照组(61.67％,P＜0.05).结论:与外用曲安奈德益康唑乳膏相比,肛肠瘙痒洗剂治疗肛周湿疹改善瘙痒症状更明显,痊愈率高.

目的 观察氨酚羟考酮片与盐酸曲马多缓释片对混合痔术后疼痛的疗效与不良反应.方法 选择100例混合痔术后首次疼痛VAS评分≥4分的患者,随机分为氨酚羟考酮组和盐酸曲马多组各50例,于术后首次疼痛评分≥4分时给予干预措施,氨酚羟考酮组口服氨酚羟考酮片1片(含盐酸羟考酮5mg和对乙酰氨基酚325mg);盐酸曲马多组口服盐酸曲马多缓释片100mg,观察服药后疼痛效果以及不良反应的发生率.结果 氨酚羟考酮组疼痛缓解时间、药效作用时间均明显优于盐酸曲马多组;氨酚羟考酮组不良反应发生率低于盐酸曲马多组,差异有显著性.结论 氨酚羟考酮片对于混合痔术后引起的疼痛有良好的镇痛效果,起效快,作用时间长,且不良反应小.

Objective To observe the clinical effect of bidirectional isobaric drainage radical resection for the treatment of high simple anal fistula.Methods A total of 120 patients with high simple anal fistula were randomly assigned to the treatment group and the control group by a random number table,with 60 cases in each group.Patients in the treatment group were treated with bidirectional isobaric drainage radical resection,while patients in the control group were treated with high seton and low ectomy surgery.The following items were observed to compare the treatment effects between groups,including 24-h postoperative uroschesis grade,24-h and 7-day postoperative pain,wound healing time,cure rate,the Wexner Incontinence Score and the 36-Item Short From Health Survey (SF-36) score after wound healing.All patients were followed up for 6 months to observe the recurrence rate.Results There was no significant difference in cure rate and 6-month recurrence rate between the two groups (P ＞0.05).Compared with the control group,24-h postoperative uroschesis grade,24-h and 7-day postoperative pain were all decreased,and the wound healing time was shortened in the treatment group (all P ＜0.01).The Wexner Incontinence Scores were decreased and the SF-36 scores were improved in the treatment group (both P ＜0.01).Conclusion Compared with the conventional high seton and low ectomy surgery,bidirectional isobaric drainage radical resection for high simple anal fistula was superior for relieving patients' local pain,decreasing uroschesis,shortening healing time,protecting anal function and improving the quality of life.

[Objective]To analyze the effect of continuous nursing on the drainage self-care ability of patients with high anal fistula after a two-way isobaric operation.[Methods]A total of 116 patients with high anal fistula admitted in our hospital from March 2015 to March 2017 were analyzed retrospectively.According to the random number table method,the patients were divided into the observation group and the control group,with 58 cases in each group.All patients were treated with bidirectional isobaric drainage.The observation group received continuous nursing after operation,and the control group received routine nursing.The treatment effect,recovery,recurrence and self-care ability score of two groups were compared,and the clinical value and application experience of continuous nursing were summarized.[Results]The total effective rate of the two groups were both 100.00％ and so there was no statistical difference between the two groups (P ＞0.05).However,the cure rate of observation group was 89.66％,which was higher than the 67.24％ in the control group;the difference was statistically significant (P ＜0.05).The wound healing time,postoperative 7d pain,VRS score and anal function Wexner score in the observation group were lower than those in the control group;the differences were statistically significant (P ＜0.05).The ESCA scores,self-care skills and health knowledge scores The observation group were higher than those in the control group;the differences were statistically significant (P ＜0.05).[Conclusion]Continuing nursing care can significantly improve patients with high anal fistula drainage after the biaxial compression self-care ability,improve in the short-term cure rate and shorten the recovery time and other aspects also have a positive effect.

Objective:To explore the clinical effect of improved Milligan-Morgan operation in the treatment of severe hemorrhoids.Methods:A total of 160 patients with severe hemorrhoids were randomly divided into treatment group and control group.The treatment group were treated with improved Milligan-Morgan operation and the control group were treated with the Milligan-Morgan operation.The two groups were observed and compared with the clinical efficacy,postoperative complications and recurrence.Results:The clinical efficacy of the treatment group was better than that of the control group (P＜0.05).The wound healing time of the treatment group was shorter than that of the control group (P＜0.05).There were statistically difference between the two groups in postoperative pain,edema,hemorrhage and anal stenosis (all P＜0.05).The treatment group was better than the control group.Two groups of patients did not relapse within six months follow-up.Conclusion:There is a significant clinical effect with improved Milligan-Morgan operation in prevention of rectal anal stricture,keeping skin bridge,reducing postoperative pain,shortening the healing time,reducing postoperative bleeding.It is worthy of clinical application.

大家都知道,人体正常细胞由于一些原因变坏了、叛变了,可能会变成癌细胞.其实人体里面还有一些细菌,一旦”叛变”,也会带来严重的后果,甚至出现危及生命的情况. 一种“叛变”的细菌,一次危及生命的“政变” 有一位X先生节日前夕忽然发烧不退,吃各种退烧药、输抗生素都无效,经确诊是盆腔感染,辗转多处就医,病情持续加重,危及生命,幸亏各经治医币用心诊治、中日友好医院肛肠科的医生及时手术才挽回了性命.究其原因,居然是一种细菌的“叛变”,这次“叛变”差点颠覆了X先生的”政权”.这种厉害的细菌到底是什么呢?

大肠癌是常见的消化道恶性肿瘤之一.在西方经济发达国家,每诞生25个婴儿,日后就有1人将患大肠癌.在我国,近20年来随着饮食习惯改变等因素的影响,大肠癌的发病率逐年上升,全国每年约有4.75万人死于大肠癌.而企业家、高管们因为工作压力及应酬的需求,患肠癌的概率也在逐年攀升.那么,如何及早发现肠癌,延缓生命呢?今天我就为大家介绍一下大肠息肉检查的疾病发现和病理诊断,以供参考.

有一位给别人看了一辈子病的医学专家,当自己被确诊为直肠癌晚期时他悲痛地说:“我要是早对便血引起重视,就不会这样了.”事实上,两年前在他刚出现便血时如果不当痔疮去治,而及时做相应检查,及时手术,完全可以有更好的结果.