透明帽辅助内镜下硬化术与传统手术治疗痔疮的疗效差异及患者预后不良的Logistic回归分析  

Logistic regression analysis of the difference in curative effect between transparent cap-assisted endoscopic sclerotherapy and traditional surgery for hemorrhoids and poor prognosis of patients

作　　者：熊英 谢长仿 杨洋[1] 韩静[1] 路璐[2] 赵振锋 侯丛然 张金卓[1] XIONG Ying;XIE Chang-fang;YANG Yang(Department of Digestive,NO.1 Central Hospital of Baoding,Baoding Hebei 071000,China;Department of Endoscopy Center,NO.1 Central Hospital of Baoding,Baoding Hebei 071000,China;Key Laboratory of Molecular Pathology and Early Diagnosis of Tumor in Hebei Province,Baoding Hebei 071000,China)

机构地区：[1]保定市第一中心医院消化内科,河北保定071000 [2]保定市第一中心医院内窥镜中心,河北保定071000 [3]河北省分子病理与肿瘤早期诊断重点实验室,河北保定071000

出　　处：《临床和实验医学杂志》2022年第7期755-758,共4页Journal of Clinical and Experimental Medicine

基　　金：保定市科技计划项目(编号:1941ZF049);河北省科技计划项目(编号:2017005412)。

摘　　要：目的探讨透明帽辅助内镜下硬化术与传统手术治疗痔疮的疗效差异及患者预后不良因素。方法前瞻性选取2017年5月至2020年10月保定市第一中心医院收治的痔疮患者120例作为研究对象,按照随机数字表法将其分为研究组及对照组,各60例。对照组予以开放式外切内扎术治疗,研究组则予以透明帽辅助内镜下硬化术治疗。观察并比较两组患者的疗效、手术相关指标、并发症发生率以及肛门部坠胀评分。并根据逻辑斯谛回归分析影响患者预后效果的独立危险因素。结果治疗后研究组患者的临床治疗总有效率90.00%,显著高于对照组(61.67%),差异有统计学意义(P<0.05)。治疗后研究组患者的手术时长、术中出血量、术后疼痛时长为(13.36±4.25)h、(13.75±4.48)mL、(8.24±3.78)h,均显著低于对照组[(41.54±12.42)h、(44.38±9.79)mL、(22.61±5.85)h],差异均有统计学意义(P<0.05)。研究组患者的总并发症发生率8.33%,均显著低于对照组(25.00%),差异有统计学意义(P<0.05)。术后12、24、48 h研究组患者的肛门部坠胀评分为(2.45±0.92)、(2.06±0.54)、(1.72±0.85)分,均显著低于对照组[(4.36±1.38)、(3.86±1.89)、(2.96±1.54)分],差异均有统计学意义(P<0.05)。通过Logistic回归分析结果显示,排便困难、手术创面感染、年龄、不良情绪均为影响痔疮患者预后不良的独立危险因素(P<0.05)。结论透明帽辅助内镜下硬化术治疗痔疮的疗效显著,可有效减轻术后疼痛,改善肛门部坠胀评分,安全性良好,且排便困难、手术创面感染、年龄、不良情绪均是影响患者预后不良的独立危险因素。Objective To explore the difference in curative effect between transparent cap-assisted endoscopic sclerotherapy and traditional surgery for hemorrhoids and the poor prognosis of patients.Methods A total of 120 patients with hemorrhoids who were admitted to NO.1 Central Hospital of Baoding from May 2017 to October 2020 were prospectively selected as the research objects,and they were divided into a study group and a control group according to the random number table method,with 60 cases in each.The control group was treated with open external incision and internal ligation,while the study group was treated with transparent cap assisted endoscopic sclerotherapy.The curative effect,surgery-related indicators,incidence of adverse complications and anal bulge score were observed and compared between the two groups,and the independent risk factors affecting the prognosis of the patients were analyzed according to Logistic regression.Results After treatment,the total effective rate of clinical treatment in the study group was 90.00%,which was significantly higher than that in the control group(61.67%),and the difference was statistically significant(P<0.05).After treatment,the operation time,intraoperative blood loss,and postoperative pain time of the study group were(13.36±4.25)h,(13.75±4.48)mL,and(8.24±3.78)h,which were significantly lower than those in the control group[(41.54±12.42)h,(44.38±9.79)mL,(22.61±5.85)h],the differences were statistically significant(P<0.05).After treatment,the total incidence of adverse complications in the study group was 8.33%,which was significantly lower than that in the control group(25.00%),and the difference was statistically significant(P<0.05).At 12 h,24 h,and 48 h after operation,the anal bulge scores of the study group were(2.45±0.92),(2.06±0.54),(1.72±0.85)points,significantly lower than those of the control group[(4.36±1.38),(3.86±1.89),(2.96±1.54)points],and the differences were statistically significant(P<0.05).Logistic regression analysis showed that defecation

关 键 词：痔疮 透明帽辅助内镜下硬化术 传统手术 预后逻辑斯谛回归分析 

分 类 号：R657.18[医药卫生—外科学]