多普勒超声引导下痔动脉结扎并直肠肛门修复术的疗效及对痔病患者肛门压力的影响  

Effect of hemorrhoid artery ligation and rectal anal repair under Doppler ultrasound guidance and its effect on anal pressure of hemorrhoids patients

作　　者：洪琛 刘伟 王红芝 杨鹏 顾卫军 李于红 HONG Chen;LIU Wei;WANG Hong-zhi;et al(General Surgery Department of Zhejiang Taizhou Enze Medical Center （Group） Enze Hospital, Taizhou , Zhefiang 318050, China)

机构地区：[1]台州恩泽医疗中心(集团)恩泽医院普外科,浙江台州318050

出　　处：《中华全科医学》2018年第1期57-59,共3页Chinese Journal of General Practice

基　　金：浙江省医学会临床科研基金项目(2012ZYC-A94)

摘　　要：目的探讨多普勒超声引导下痔动脉结扎并直肠肛门修复术的临床疗效及对痔病患者肛门压力的影响。方法采用随机数字法将2014年12月—2016年12月台州恩泽医疗中心(集团)恩泽医院收治的206例Ⅲ~Ⅳ期痔病患者分为2组,每组103例。对照组采用外剥内扎术治疗,观察组采用多普勒超声引导下痔动脉结扎并肛门修复术治疗。治疗后,比较2组临床疗效、术后并发症评分(出血、水肿、尿潴留、坠胀感)、术后VAS评分、肛门直肠测压(ARP、RRP、AMCP)的变化及近期复发情况。结果治疗后,观察组总有效率为97.06%,明显高于对照组的89.32%(P<0.05)。观察组出血、水肿、尿潴留、坠胀感评分均低于对照组,差异有统计学意义(均P<0.05)。术后,观察组VAS评分显著低于对照组,差异有统计学意义(P<0.05)。治疗前,2组ARP、BRP、AMCP差异无统计学意义(均P>0.05);治疗后,2组ARP、BRP、AMCP均明显下降(均P<0.05),观察组ARP、BRP、AMCP水平明显高于对照组,差异有统计学意义(均P<0.05)。2组近期复发率比较,差异不具有统计学意义(P>0.05)。结论多普勒超声引导下痔动脉结扎并直肠肛门修复手术对痔病疗效显著,可明显降低患者术后并发症,减轻患者疼痛感,稳定患者正常的肛门收缩功能。Objective To investigate the effect of hemorrhoid artery ligation and rectal anal repair under Doppler ultrasound guidance and its effect on anal pressure of hemorrhoids patients. Methods Two hundred and six patients with stage Ⅲ-Ⅳ hemorrhagic disease were randomly divided into two groups, each 103 cases. The control group was treated with external stripping ligation, and the observation group was treated with hemorrhoid artery ligation and rectal anal repair under Doppler ultra- sound guidance. After treatment, the clinical efficacy, postoperative complications（bleeding, edema, urinary retention, bulging sense）, postoperative VAS score, anorectal manometry（ARP, RRP, AMCP） and recent recurrence of the two groups were compared. Results After treatment, the total effective rate of observation group was 97.06%, which was significantly higher than that of control group （89.32%）, P 〈 0. 05. The bleeding, edema, urinary retention and bulging scores of observation group were lower than those of control group, the difference was statistically significant （P 〈 0.05 ）. After operation, the VAS score of observation group was significantly lower than that of control group, the difference was statistically significant（P 〈 0.05）. After treatment, the ARP, BRP and AMCP levels of two groups were significantly reduced （P 〈 0.05 ）, and observation group was significantly higher than those of control group, the difference was statistically significant （P 〈 0.05 ）. There was no significant difference in the recurrence rate between the two groups（P 〉 0.05）. Conclusion Hemorrhoid artery ligation and rectal anal repair under Doppler ultrasound guidance could treat hemorrhoid disease significantly, significantly reduce the postoperative complications, reduce pain, and stable normal anal contraction function.

关 键 词：痔 多普勒超声引导下痔动脉结扎并直肠肛门修复术 肛门压力 

分 类 号：R657.18[医药卫生—外科学]