单纯痔动脉结扎内痔悬吊术治疗老年出血性内痔的疗效分析  

Efficacy analysis of hemorrhoid artery ligation and internal hemorrhoidal suspension in the treatment of elderly patients with bleeding internal hemorrhoids

作　　者：孙欣华 SUN Xin-hua(Anorectal Department,Dalian University Affiliated Zhongshan Hospital,Dalian 116001,China)

机构地区：[1]大连大学附属中山医院肛肠科,116001

出　　处：《中国实用医药》2023年第11期65-67,共3页China Practical Medicine

摘　　要：目的分析单纯痔动脉结扎内痔悬吊术治疗老年出血性内痔的临床疗效。方法58例老年出血性内痔患者为研究对象,依据治疗方法不同分为研究组(26例)与对照组(32例)。对照组采用传统混合痔外剥内扎术治疗,研究组采用单纯痔动脉结扎内痔悬吊术治疗。比较两组临床指标(手术时间、术中出血量、术后疼痛评分与肛缘水肿评分、恢复时间),观察术后并发症发生情况及复发情况。结果58例患者均手术顺利,术后平稳恢复,术前内痔出血情况均得到有效控制,术后6个月电话随访,两组患者均未复发。两组术中出血量比较,差异无统计学意义(P>0.05)。研究组手术时间(18.69±1.35)min、恢复时间(10.15±0.96)d短于对照组的(32.41±5.41)min、(30.41±1.88)d,术后疼痛评分(2.85±0.46)分、术后肛缘水肿评分(1.19±0.63)分低于对照组的(5.13±0.49)、(2.88±0.83)分,差异有统计学意义(P<0.05)。两组术后均未发生肛管狭窄。研究组术后未发生脱核期出血情况,对照组中1例患者在术后第4天脱核期出现排便伴少量细小暗红色凝血块情况,通过软化大便、应用保护性栓剂等治疗,症状改善平稳恢复。结论单纯痔动脉结扎内痔悬吊术及混合痔外剥内扎术均为出血性内痔的有效治疗方法,但是针对老年患者群体,仅行痔动脉结扎内痔悬吊术对出血的内痔进行手术切除,具有手术时间快、创伤小、疼痛轻、恢复快、并发症少等特点,更适用于老年出血性内痔的临床治疗。Objective To analyze the clinical efficacy of hemorrhoid artery ligation and internal hemorrhoidal suspension in the treatment of elderly patients with bleeding internal hemorrhoids.Methods A total of 58 elderly patients with bleeding internal hemorrhoids were studied,and were divided into research group(26 cases)and control group(32 cases)according to different treatment methods.The control group was treated with conventional milligan-morgan hemorrhoidectomy,while the research group was treated with hemorrhoid artery ligation and internal hemorrhoidal suspension.The clinical indicators(operative time,intraoperative blood loss,postoperative pain score and anal edema score,recovery time)were compared between the two groups,and the occurrence of postoperative complications and recurrence were observed.Results All 58 patients underwent successful surgery,recovered smoothly after surgery,and all preoperative internal hemorrhoid bleeding was effectively controlled,with no recurrence in either group at 6-month postoperative telephone follow-up.There was no statistically significant difference in intraoperative blood loss between the two groups(P>0.05).The operative time of(18.69±1.35)min and recovery time of(10.15±0.96)d in the research group was shorter than that of(32.41±5.41)min and(30.41±1.88)d in the control group;the postoperative pain score of(2.85±0.46)points and postoperative anal edema score of(1.19±0.63)points in the research group were lower than those of(5.13±0.49)and(2.88±0.83)points in the control group;all differences were statistically significant(P<0.05).No anal canal stricture occurred in both groups after surgery.In the research group,no bleeding occurred during the period of nucleation after surgery.In the control group,1 patient showed defecation accompanied by a small amount of dark red clot during the period of nucleation on the 4th day after surgery.The symptoms were improved and recovered steadily by softening the stool and applying protective suppositories.Conclusion Both hemorrhoid a

关 键 词：出血性内痔 痔动脉结扎内痔悬吊术 混合痔外剥内扎术 老年人 

分 类 号：R657.18[医药卫生—外科学]