透明帽辅助内镜下泡沫硬化剂治疗内痔的初步研究  

Transparent cap assisted endoscopic foam sclerotherapy for internal hemorrhoids:a preliminary study

作　　者：黄宏春[1] 张海波 孟敏[1] 陈芳洁[1] 王秀敏[1] 郭长青[2] Huang Hongchun;Zhang Haibo;Meng Min;Chen Fangjie;Wang Xiumin;Guo Changqing(Department of Gastroenterology,the Anyang People's Hospital,Anyang 455000,China;Department of Gastroenterology,the First Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]安阳市人民医院消化内科,455000 [2]郑州大学第一附属医院消化内科,450052

出　　处：《中华结直肠疾病电子杂志》2020年第6期621-624,共4页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：河南省医学科技攻关项目(No.2018021010)。

摘　　要：目的探讨应用泡沫硬化剂进行透明帽辅助内镜下硬化术(CAES)治疗内痔的临床效果和安全性。方法将346例2018年1月至2019年12月安阳市人民医院收治的Ⅰ~Ⅲ期内痔患者,应用临床随机对照试验方法分为聚桂醇泡沫硬化剂治疗组(195例)和聚桂醇原液硬化剂治疗对照组(151例),进行CAES治疗,随访4周。观察治疗的临床疗效,耐受性,术中、术后不良反应及并发症。结果治疗4周后治疗组165例(84.6%)痊愈,28例(14.4%)好转,2例(1%)无效,总有效率99.0%。优于对照组(91.4%)(χ2=47.475,P<0.001)。治疗后治疗组185例(94.9%)没有或仅感觉轻微疼痛不适,8例(4.1%)出现中度疼痛;2例(1.0%)出现严重疼痛。对照组112例(74.2%)没有或仅感觉轻微疼痛不适,34例(22.5%)出现中度疼痛;5例(3.3%)出现严重疼痛。治疗组耐受性优于对照组(χ2=30.217,P<0.001)。并发症方面,治疗组1例(0.5%)、对照组2例(1.3%)出现短暂性尿潴留,对症处置后缓解。两组均未出现严重出血、局部感染等严重并发症。结论采用聚桂醇泡沫硬化剂,进行CAES治疗内痔,安全、有效、值得推广。Objective This preliminary study was to evaluate the efficacy,safety in the treatment of internal hemorrhoids with foam sclerosant under transparent cap assisted endoscopic sclerotherapy(CAES).Methods 346 patients with gradeⅠtoⅢinternal hemorrhoids were admitted from January 2018 to December 2019.195 cases were treated with lauromacrogol foam sclerosant.151 cases were treated with lauromacrogol sclerosant.The follow up period was 4 weeks.The efficacy,intraoperative and postoperative complications were evaluated.Results The patients in treatment group were evaluated for efficacy after treatment.165(84.6%)cases were cured,28(14.4%)cases were improved,and 2(1.0%)case were ineffective.The total effective rate was 99.0%in treatment group and 91.4%in control group(χ2=47.475,P<0.001).In treatment group,185(94.9%)cases presented mild/no pain,8(4.1%)cases presented moderate pain,and 2(1.0%)cases presented severe pain.In control group,112(74.2%)cases presented mild/no pain,34(22.5%)cases presented moderate pain,and 5(3.3%)cases presented severe pain.The treatment group had better tolerability than the control group(χ2=30.217,P<0.001).There were 1(0.5%)case occurred transient uroschesis in treatment group and 2(1.3%)cases in control group.All cases were relieved after symptomatic treatment.There were no complications such as infection,major bleeding.Conclusion CAES with foam sclerosant is effective and high safety.It is worthy of clinical application.

关 键 词：痔 内镜 泡沫硬化剂 聚桂醇 

分 类 号：R657.18[医药卫生—外科学]