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作 者:钟婷 庞文璟 王磊[1] 陈会松 孟祥军[1] ZHONG Ting;PANG Wenjing;WANG Lei;CHEN Huisong;MENG Xiangjun(Department of Gastroenterology,Shanghai Key Laboratory of Gut Microecology and Associated Major Diseases Research,Center for Digestive Diseases Research and Clinical Translation of Shanghai Jiao Tong University,Shanghai Ninth People’s Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200011,China)
机构地区:[1]上海交通大学医学院附属第九人民医院消化科上海市消化道微生态及相关重大疾病研究重点实验室上海交通大学消化疾病研究与临床转化中心,200023
出 处:《国际消化病杂志》2022年第6期378-382,392,共6页International Journal of Digestive Diseases
摘 要:目的比较内镜下硬化剂注射与橡胶圈套扎治疗内痔患者的疗效、并发症、预后等,以期为内镜下微创治疗内痔提供参考。方法选择2021年1月至2021年12月在上海交通大学医学院附属第九人民医院接受内镜下微创治疗的53例内痔及混合痔患者,按照随机数表法分为2组,分别采用内镜下硬化剂(聚多卡醇泡沫)注射(设为硬化组,n=27)和内镜下橡胶圈套扎(设为套扎组,n=26)治疗,记录2组的基本临床资料、治疗后疼痛和出血情况,比较2组的疗效、并发症、复发率和住院时间等。结果以内痔脱垂为主要症状的患者共16例,套扎组治疗有效率为100.00%,硬化组治疗有效率为75.00%,差异有统计学意义(P<0.05)。以便血为主要症状的患者共37例,套扎组治疗有效率为77.78%,硬化组治疗有效率为94.74%,差异有统计学意义(P<0.05)。套扎组治疗后的视觉模拟评分法(VAS)评分高于硬化组,差异有统计学意义(P=0.047)。治疗后3个月,硬化组中有2例(7.41%)患者复发,套扎组中有6例(23.08%)患者复发,差异无统计学意义(P>0.05)。结论内镜下橡胶圈套扎对于内痔脱垂的治疗有效率明显高于内镜下硬化剂注射,但前者的治疗后疼痛较后者明显。内镜下硬化剂注射对于便血的治疗有效率明显高于内镜下橡胶圈套扎。Objective This paper intends to compare the efficacy,complications and prognosis of sclerosing agent injection and rubber snare ligation in the treatment of internal hemorrhoids under endoscope,so as to provide reference for minimally invasive treatment of internal hemorrhoids under endoscope.Methods From January 2021 to December 2021,fifty-three patients with internal hemorrhoids and mixed hemorrhoids who received endoscopic minimally invasive treatment in Shanghai Ninth People’s Hospital,School of Medicine,Shanghai Jiao Tong University were selected and assigned to two groups according to the random number table.Endoscopic sclerosing agent(polydocanol foam)injection(set as sclerosing group,n=27)and endoscopic rubber snare ligation(set as ligating group,n=26)were used for treatment respectively.The basic clinical data,pain and bleeding after treatment of the two groups were recorded,and the efficacy,complications,recurrence rate and hospital stay of the two groups were compared.Results There are 16 patients with prolapse of internal hemorrhoids as the main symptom.The efective rate is 100.00%in the ligation group and 75.00%in the sclerotherapy group,with a statistically significant diference(P<0.05).There are 37 patients with hematochezia as the main symptom.The efective rate of the ligation group is 77.78%,and that of the sclerotherapy group is 94.74%,with a statistically significant diference(P<0.05).The visual analogue scale(VAS)score in the ligation group is higher than that in the sclerotic group after treatment,with a statistically significant difference(P=0.047).Three months after treatment,2 patients(7.41%)in the sclerotic group recurred,and 6 patients(23.08%)in the ligation group recurred,with no significant diference(P>0.05).Conclusions The efective rate of endoscopic rubber snare ligation for prolapse of internal hemorrhoids is significantly higher than that of endoscopic sclerosing agent injection,but the pain of the former is more obvious than that of the latter.The effective rate of sclerosing ag
关 键 词:内痔 内镜下橡胶圈套扎治疗 内镜下硬化剂注射治疗 疗效 并发症
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