射频消融术改善内痔出血症状的临床疗效观察  

Clinical observation of the effectiveness of radiofrequency ablation on improving internal hemorrhoidal bleeding symptom

作　　者：朱志红 曹莫寒 王志民 李涛 武国亮 吴现海 杨滕滕 Zhu Zhihong;Cao Mohan;Wang Zhimin;Li Tao;Wu Guoliang;Wu Xianhai;Yang Tengteng(Department of Anorectal Surgery,People’s Hospital of Chengyang District,Qingdao,Qingdao 266109,Shandong,China;Department of Anorectal Surgery,The First Affiliated Hospital of Shandong First Medical University,Jinan 250014,Shandong,China;Department of Anorectal Surgery,Shandong Second Provincial General Hospital,Jinan 250022,Shandong,China)

机构地区：[1]青岛市城阳区人民医院肛肠科,山东青岛266109 [2]山东第一医科大学第一附属医院肛肠科,山东济南250014 [3]山东省第二人民医院肛肠科,山东济南250022

出　　处：《结直肠肛门外科》2023年第6期592-596,共5页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨射频消融术改善内痔出血症状的临床疗效。方法以2022年6月至2023年3月在山东省第二人民医院和山东第一医科大学第一附属医院接受治疗的160例存在内痔出血症状的患者为研究对象,按照手术方式的不同,将患者分为治疗组(n=80,采用射频消融术处理内痔,外痔视情况可予单纯切除治疗)与对照组(n=80,采用Milligan-Morgan术治疗)。记录并比较两组的手术相关指标(术中出血量、术后第1天创面VAS疼痛评分、创面愈合时间),术后3个月内的肛门情况(肛门出血、肛门狭窄、肛门坠胀、肛门失禁)和术后6个月的治愈情况。结果治疗组术中出血量少于对照组,创面愈合时间较对照组提前,差异有统计学意义(P<0.05),两组术后第1天创面VAS疼痛评分比较差异无统计学意义(P>0.05)。术后3个月内,两组均无肛门失禁病例;治疗组肛门狭窄、肛门坠胀发生率低于对照组,差异有统计学意义(P<0.05),两组肛门出血发生率比较差异无统计学意义(P>0.05)。术后6个月,治疗组治愈率高于对照组,差异有统计学意义(P<0.05)。结论射频消融术改善内痔出血症状可以取得较好的效果,患者的治愈率高。Objectives To investigate the clinical effectiveness of radiofrequency ablation(RFA)on improving internal hemorrhoidal bleeding symptom.Methods A total of 160 patients with internal hemorrhoidal bleeding symptom treated at Shandong Second Provincial General Hospital and The First Affiliated Hospital of Shandong First Medical University from June 2022 to March 2023 were enrolled.Patients were divided into a treatment group(n=80,treated with RFA for internal hemorrhoids,and external hemorrhoids were treated with simple resection if necessary)and a control group(n=80,treated with Milligan-Morgan procedure).Surgical-related indicators(intraoperative blood loss,would pain score evaluated by Visual Analogue Scale on the first day after surgery,wound healing time),anal conditions within 3 months after surgery(anal bleeding,anal stricture,anal distention,anal incontinence),and the cure rate at 6 months after surgery were recorded and compared between the two groups.Results Intraoperative blood loss in the treatment group was less than that in the control group,and the wound healing time was earlier than that in the control group,with statistically significant differences(P<0.05).No statistically significant difference was observed in the would pain score on the first day after surgery(P>0.05).Within 3 months after surgery,no cases of anal incontinence were reported in both groups.The incidences of anal stricture and anal distention in the treatment group were lower than that in the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the incidence of anal bleeding between the two groups(P>0.05).At 6 months after surgery,the cure rate in the treatment group was higher than that in the control group,with statistically significant difference(P<0.05).Conclusion RFA treatment for internal hemorrhoidal bleeding symptom can achieve good results and has a high cure rate.

关 键 词：痔 内痔出血症状 射频消融术 MILLIGAN-MORGAN术 

分 类 号：R657.1[医药卫生—外科学]