内镜下三种微创方案治疗内痔的疗效及安全性评价  

Efficacy and safety of three minimally invasive endoscopic procedures for the treatment of internal hemorrhoids

作　　者：肖梅 王慧群 贾勇 郑帮海 许朝 王松[1] 张开光 张明黎 余跃 吴正祥 Xiao Mei;Wang Huiqun;Jia Yong;Zheng Banghai;Xu Chao;Wang Song;Zhang Kaiguang;Zhang Mingli;Yu Yue;Wu Zhengxiang(Department of Gastroenterology,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]中国科学技术大学附属第一医院消化内科,合肥230001

出　　处：《中华消化内镜杂志》2023年第3期224-228,共5页Chinese Journal of Digestive Endoscopy

摘　　要：为了评价内镜下内痔治疗的安全性和有效性,对中国科学技术大学附属第一医院2018年1月—2020年6月行内镜下治疗且有完整随访资料的166例Ⅰ~Ⅲ度内痔病例进行了回顾性总结,其中单纯硬化组35例、单纯套扎组104例、套扎联合硬化组27例。结果显示:3组术后均未出现严重并发症,单纯套扎组和套扎联合硬化组术后肛门疼痛发生率[分别为35.6%(37/104)和33.3%(9/27)]和肛门坠胀感发生率[分别为70.2%(73/104)和70.4%(19/27)]均较高,但一般均可耐受或经简单处理后缓解;出院前,3组的患者满意度均达90%以上,手术接受程度均达95%以上;3组术后3个月时的治疗有效率均在90.0%以上,术后12个月时的治疗有效率均有不同程度下降,其中单纯硬化组的治疗有效率最低[74.3%(26/35)],其他2组的治疗有效率仍能维持在85.0%以上。由此可见,内镜下微创治疗内痔是一种安全有效的治疗方法,具有有效改善症状、患者术后满意度和手术接受程度高等特点。In order to evaluate the safety and effectiveness of endoscopic hemorrhoids treatment,a retrospective analysis was conducted on data of 166 patients with grade I toⅢhemorrhoids who underwent endoscopic treatment in the First Affiliated Hospital of University of Science and Technology of China from January 2018 to June 2020 with complete follow-up data.There were 35 cases in the simple sclerotherapy group,104 cases in the simple ligation group,and 27 cases in the ligation combined sclerotherapy group.The results showed that,no serious complications occurred in the 3 groups after surgery.In the simple ligation group and the ligation combined with sclerotherapy group,the incidence of postoperative anal pain[35.6%(37/104)and 33.3%(9/27),respectively,]and anal pendant distension[70.2%(73/104)and 70.4%(19/27),respectively]were higher,but symptoms could be tolerated or relieved after simple treatment.The satisfaction of patients in the 3 groups was all more than 90%before discharge,and the degree of operation acceptance was more than 95%.The effective rate of the 3 groups was above 90.0%at 3 months after surgery,At 12 months after surgery,the effective rate of the simple sclerotherapy group was the lowest[74.3%(26/35)],and the effective rate of the other two groups was still above 85.0%.In conclusion,minimally invasive treatment for internal hemorrhoids under endoscopy is safe and effective with effective improvement of symptoms,high postoperative satisfaction of patients and high degree of acceptance.

关 键 词：痔 内痔 内镜下套扎术 内镜下硬化术 并发症 疗效 

分 类 号：R657.18[医药卫生—外科学]