3例痔术后难治性出血患者介入治疗的即刻疗效与长期预后  

Immediate efficacy and long-term prognosis analysis of 3 cases interventional treatment of refractory bleeding after hemorrhoidal surgery

作　　者：崔振华 李志文[2] 王贤仁[2] 刘贞吉[2] 商庆新 吕艳锋 CUI Zhenhua;LI Zhiwen;WANG Xianren;LIU Zhenji;SHANG Qingxin;LYU Yanfeng(College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250355,Shandong,China;Department of Colorectal and Anal Surgery,The Second Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250033,Shandong,China)

机构地区：[1]山东中医药大学中医学院,山东济南250355 [2]山东大学第二医院结直肠肛门外科,山东济南250033

出　　处：《山东大学学报（医学版）》2023年第5期68-72,共5页Journal of Shandong University:Health Sciences

基　　金：山东省重点研发计划项目公益类专项(2019GSF108136);山东省医学会临床科研资金-齐鲁专项(YXH2022ZX02118);山东大学第二医院培育基金(2022YP21)。

摘　　要：目的 探讨痔手术后难治性出血经介入治疗的即刻疗效及长期预后。方法 回顾性分析3例行介入治疗的痔手术后反复多次出血患者的临床资料,随访时间分别为114个月、110个月、78个月,3例患者均经造影后明确出血部位,分别为左侧直肠上动脉分支末端造影剂外溢、直肠上动脉分支末端造影剂外溢和左侧髂内动脉末端血管造影剂外溢;2例一次栓塞成功,1例栓塞后再次出血行第二次介入治疗后成功止血。3例患者经介入治疗后均未再出血。结果 3例患者均止血确切,无肠坏死、死亡等严重并发症,均有肛门下坠、疼痛症状;1例出现阴囊水肿、勃起障碍,长期随访后又恢复。结论 介入栓塞治疗难治性痔术后持续性出血,即刻疗效显著,但安全性需要多中心及大样本的长期随访与观察。Objective To investigate the immediate efficacy and long-term prognosis of patients with repeated bleeding after interventional therapy.Methods The clinical data of three patients with repeated bleeding after hemorrhoidal surgery were retrospectively analyzed at the follow-up of 114,110 and 78 months,respectively.The bleeding sites were the end of the left superior rectal artery,the end of the superior rectal artery branch and the end of the left internal iliac artery.Two cases had successful first-stage embolization,and one case had re-bleeding after first-stage embolization and successfully stopped bleeding after a second interventional treatment.No patients had bleeding after interventional treatment.Results All three patients had accurate hemostasis,and there were no serious complications such as intesti-nal necrosis and death.All patients had falling and painful symptoms;One patient developed scrotal edema and erectile dysfunction,and recovered after long-term follow-up.Conclusion Interventional embolization is effective in the treat-ment of persistent bleeding after refractory hemorrhoids,but the safety requires long-term follow-up and observation of multi-center and large samples.

关 键 词：痔 术后 出血 介入 栓塞 

分 类 号：R657[医药卫生—外科学]