断流固脱止血三步注射法治疗Ⅲ度内痔的临床疗效  

Clinical efficacy of three-step(blood occlusion,preventing prolapse and stopping bleeding) injection method in treatment of third-degree internal hemorrhoids

作　　者：罗泽昊 梅祖兵[1] 仇菲[1] 何峥[1] 刘肃志 陆宏[1] 张志君[1] 芦亚峰[1] 方臣阳 杜培欣[1] 杨巍[1] LUO Zehao;MEI Zubing;QIU Fei;HE Zheng;LIU Suzhi;LU Hong;ZHANG Zhijun;LU Yafeng;FANG Chenyang;DU Peixin;YANG Wei(Anorectal Department,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院肛肠科,上海201203

出　　处：《上海中医药大学学报》2024年第1期42-46,60,共6页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：上海市科委科技计划项目(20Y21901000)。

摘　　要：目的:比较断流固脱止血三步注射法与内痔结扎术治疗Ⅲ度内痔的临床疗效。方法:纳入Ⅲ度内痔患者72例,随机分为试验组和对照组,每组各36例。试验组患者采用断流固脱止血三步注射法治疗,对照组患者采用内痔结扎术治疗。比较两组患者的临床疗效和恢复正常生活工作时间;评价便血、痔核脱出等临床症状及疼痛、发热、肛门坠胀等术后并发症发生情况;采用B型超声检查测定所有患者的痔动脉数量及痔动脉收缩期峰值血流速度(PSV),比较两组患者的痔动脉数量及PSV下降比。结果:研究过程中,试验组1例患者被剔除,对照组1例患者失访,最终纳入统计分析者试验组35例、对照组35例。(1)术后1个月,试验组患者的总显效率为100.0%,对照组为97.1%,两组临床疗效比较,差异无统计学意义(P>0.05)。(2)术后,两组患者的便血、痔核脱出症状评分较术前均显著降低(P<0.05),且术后第7天试验组患者的便血症状评分低于对照组(P<0.05)。(3)术后第1、3、7天,试验组患者的疼痛评分、肛门坠胀发生率明显低于对照组(P<0.05);术后第1、3天,试验组患者的排便情况评分明显低于对照组(P<0.05);术后第1天,试验组患者的尿潴留发生率明显低于对照组(P<0.05)。(4)试验组患者的术后恢复正常生活工作时间较对照组明显缩短(P<0.05)。(5)术后,两组患者的痔动脉数量及PSV较术前均显著下降(P<0.05),且试验组患者的痔动脉数量、PSV下降比显著高于对照组(P<0.05,P<0.01)。结论:与内痔结扎术相比,断流固脱止血三步注射法能明显缩短Ⅲ度内痔患者术后恢复正常生活工作时间,改善痔核脱出、便血症状,减轻术后并发症,降低痔动脉区血流的过度灌注。Objective:To compare the clinical efficacy of three-step(blood occlusion,preventing prolapse and stopping bleeding) injection method and internal hemorrhoids ligation in the treatment of third-degree internal hemorrhoids.Methods:A total of 72 patients with third-degree internal hemorrhoids were included and randomly divided into the experimental group and control group,36 cases in each group.The patients in the experimental group were treated with three-step((blood occlusion,preventing prolapse and stopping bleeding) injection method,and the patients in the control group were treated with internal hemorrhoids ligation.The clinical efficacy and the time to resuming normal life and work were compared between the two groups.The clinical symptoms such as hematochezia and hemorrhoids prolapse and postoperative complications including pain,pyrexia,anal swelling,and so on were evaluated.The number and the peak systolic blood flow velocity(PSV) of hemorrhoidal arteries were measured by B-mode ultrasound,and the reduction ratio of hemorrhoidal artery number and PSV were compared between the two groups.Results:During the course of the study,one patient was excluded in the experimental group,and one patient was lost to follow-up in the control group.Finally,35 cases in the experimental group and 35 cases in the control group were included in the statistical analysis.(1)One month after surgery,the total markedly effective rate was 100.0% in the experimental group and 97.1% in the control group,with no statistically significant difference between the two groups(P>0.05).(2)After surgery,the scores of hematochezia and hemorrhoids prolapse symptoms in the two groups were significantly decreased compared with those before surgery(P<0.05),and on the 7th day after surgery,the score of hematochezia symptom in the experimental group was lower than that in the control group(P<0.05).(3)On the 1st,3rd and 7th days after surgery,the pain score and the incidence rate of anal swelling in the experimental group were significantly lower than

关 键 词：内痔 内痔注射疗法 内痔结扎术 痔血流动力学 

分 类 号：R266[医药卫生—中医外科学]