自动弹力线痔疮套扎术联合外切内扎术与透明帽辅助内镜下硬化术治疗重度痔疮的疗效对比  

Comparison on curative effect of automatic elastic thread hemorrhoid ligation combined with external incision and internal ligation and transparent cap assisted endoscopic sclerotherapy in the treatment of severe hemorrhoids

作　　者：周海华[1] 李迎春[2] 翟恒勇 王小冬[2] 韩宁 Zhou Haihua;Li Yingchun;Zhai Hengyong;Wang Xiaodong;Han Ning(Department of general surgery,Taizhou people's hospital affiliated to Nanjing Medical University,Taizhou,Jiangsu,225300,China;Department of anus and intestine surgery,Taizhou people's hospital affiliated to Nanjing Medical University,Taizhou,Jiangsu,225300,China;Gastrology department(endoscopy center),Taizhou people's hospital affiliated to Nanjing Medical University,Taizhou,Jiangsu,225300,China)

机构地区：[1]南京医科大学附属泰州市人民医院普外科,江苏泰州225300 [2]南京医科大学附属泰州市人民医院肛肠外科,江苏泰州225300 [3]南京医科大学附属泰州市人民医院消化内科(内镜中心),江苏泰州225300

出　　处：《齐齐哈尔医学院学报》2022年第23期2257-2260,共4页Journal of Qiqihar Medical University

摘　　要：目的探究自动弹力线痔疮套扎术联合外切内扎术与透明帽辅助内镜下硬化术治疗重度痔疮的的疗效对比。方法选择2019年4月—2022年4月本院肛肠外科收治的重度痔疮患者70例作为研究对象,将其分为对照组和观察组两组,每组各35例。对照组患者予以自动弹力线痔疮套扎术联合外切内扎术治疗,观察组患者予以透明帽辅助内镜下硬化术治疗。对两组患者临床疗效、手术相关指标、血清应激指标、术后并发症发生率进行对比分析。结果观察组患者总有效率优于对照组(P<0.05)。与对照组相比,观察组患者的手术时间较短、术中出血量较少、术后视觉模拟疼痛评分(VAS)较低、住院时间较短,差异均有统计学差异(P<0.05)。术前两组患者血清中肾上腺素(A)、去甲肾上腺素(NE)、皮质醇(Cor)、C反应蛋白(CRP)表达水平比较,差异均无统计学意义(P>0.05);术后两组患者血清中A、NE、Cor、CRP表达水平均较术前有所上升,差异有统计学意义(P<0.05);观察组表达水平低于对照组,差异有统计学意义(P<0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论透明帽辅助内镜下硬化术治疗对重度痔疮患者疗效较好,治疗总有效率高、疼痛轻、出血少,且术后并发症发生情况有效减少,临床应用价值较高。Objective To compare the efficacy of automatic elastic thread hemorrhoid ligation combined with external incision and internal ligation and transparent cap assisted endoscopic sclerotherapy in the treatment of severe hemorrhoids.Methods Seventy patients suffered from severe hemorrhoids those were admitted to the anorectal surgery department of Taizhou people's hospital affiliated to Nanjing Medical University from April 2019 to April 2022 were selected as the subjects of this study.They were equally divided into two groups according to random number table method,with thirty-five patients in each group.The patients in the control group were treated with automatic elastic thread hemorrhoids ligation combined with external incision and internal ligation,and the patients in the observation group were treated with transparent cap assisted endoscopic sclerotherapy.The clinical efficacy,surgical indexes,serum stress indexes and incidence of postoperative complications of the two groups were compared and analyzed.Results The total effective rate of the observation group was better than that of the control group,with statistical difference(P<0.05).Compared with the control group,the patients in the observation group had shorter operation time,less intraoperative bleeding,lower visual analog pain score(VAS)after operation,and shorter hospital stay,all differences were statistically significant(P<0.05).There were no significant differences in the expression levels of adrenaline(A),norepinephrine(NE),cortisol(Cor)and C-reactive protein(CRP)in serum between the two groups before operation(P>0.05).After operation,the expression levels of A,NE,Cor and CRP in serum of patients in the two groups were higher than those before operation,with statistical difference(P<0.05);The expression levels in the study group were lower than those in the control group,with statistical significance(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusions Endoscopic scle

关 键 词：重度痔疮 自动弹力线痔疮套扎术 外切内扎术 透明帽辅助内镜下硬化术 

分 类 号：R657.18[医药卫生—外科学]