直肠上动脉介入栓塞术对内痔患者的临床安全有效性分析  

Clinical safety and effectiveness of upper rectal artery embolization in patients with internal hemorrhoids

作　　者：卢精华 刘启学 吴春艳 苏玉光 LU Jinghua;LIU Qixue;WU Chunyan;SU Yuguang(Department of Proctology,Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao,Hebei,066000;Department of Intervention,Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao,Hebei,066000)

机构地区：[1]河北省秦皇岛市中医医院肛肠科,河北秦皇岛066000 [2]河北省秦皇岛市中医医院介入科,河北秦皇岛066000

出　　处：《实用临床医药杂志》2023年第9期119-122,共4页Journal of Clinical Medicine in Practice

基　　金：河北省医学科学研究课题计划项目(20201327)。

摘　　要：目的探讨直肠上动脉介入栓塞术治疗Ⅱ~Ⅳ度内痔的临床安全性和有效性。方法选取确诊为内痔Ⅱ~Ⅳ度的患者72例为研究对象,按照随机数字表法将其分为痔上黏膜环形切除钉合术(PPH)组及栓塞术组,每组36例。栓塞术组患者采用直肠上动脉介入栓塞术进行干预,PPH组患者采用PPH术式进行干预。比较2组患者围术期各项指标、术后并发症、临床疗效及术后肛门症状相关评分情况,观察患者内痔复发情况。结果栓塞术组临床治疗总有效率高于PPH组,差异有统计学意义(P<0.05);栓塞术组手术时间、住院时间、术中出血量、创面愈合时间与PPH组比较,差异有统计学意义(P<0.05);栓塞术组术后症状评分及并发症总发生率均低于PPH组,差异有统计学意义(P<0.05)。Kaplan-Meier曲线联合Log-rank检验显示,2组术后9个月复发情况比较,差异无统计学意义(P=0.09)。结论直肠上动脉栓塞术对以出血为主的Ⅱ~Ⅳ度内痔有良好的疗效,对提高临床治疗有效率、促进患者快速恢复及改善临床不良反应具有积极意义。Objective To investigate the clinical safety and effectiveness of upper rectal artery embolization in the treatment of gradeⅡtoⅣinternal hemorrhoids.Methods A total of 72 patients diagnosed with gradeⅡtoⅣinternal hemorrhoids were selected as study objects.A random number table method was used to divide these patients into postpartum hemorrhage(PPH)group and embolization group,with 36 cases in each group.Embolization group was treated with upper rectal artery embolization,and PPH group was treated with PPH operation.Perioperative indicators,postoperative complications,clinical efficacy and postoperative anal symptoms were compared between the two groups,and the recurrence of internal hemorrhoids was observed.Results The total effective rate of embolization group was higher than that of the PPH group(P<0.05).The operative time,hospital stay,intraoperative blood loss and wound healing time of the embolization group showed statistically significant differences compared with those of the PPH group(P<0.05).The score of postoperative symptoms and the total incidence of complications in the embolization group were lower than those in the PPH group,and the differences were statistically significant(P<0.05).Kaplan-Meier curve combined with Log-rank test showed no statistical significance difference in recurrence 9 months after surgery was seen between the two groups(P=0.09).Conclusion The upper rectal artery embolization has a good effect in the treatment ofⅡtoⅣdegree of hemorrhoids mainly manifesting as bleeding,and has positive significance in improving the clinical efficiency,promoting the rapid recovery and improving the clinical adverse symptoms.

关 键 词：内痔 直肠上动脉介入栓塞术 临床疗效 安全性 并发症 不良反应 

分 类 号：R657.1[医药卫生—外科学] R659[医药卫生—临床医学]