经内镜痔上直肠黏膜套扎与痔核套扎治疗内痔出血疗效及安全性的比较  

Comparison of the efficacy and safety of super-hemorrhoidal banding and hemorrhoidal band ligation in the treatment of internal hemorrhoidal bleeding

作　　者：吴诗虹 李呈光 朱卫芳[2] 袁华兵[2] 刘云华[2] 沈永祥[2] 李正法[2] 笪荣峰 徐湖波[2] 陈友平 WU Shi-hong;LI Cheng-guang;ZHU Wei-fang;YUAN Hua-bing;LIU Yun-Hua;SHEN Yong-xiang;LI Zheng-fa;DA Rong-feng;XU Hu-bo;CHEN You-ping(School of Medicine,Wuhan University of Science and Technology,430065 Wuhan,Hubei,China;Department of Digestive Medicine,Tianmen First People's Hospital,431700 Tianmen,Hubei,China)

机构地区：[1]武汉科技大学医学院,湖北武汉430000 [2]天门市第一人民医院消化内科,湖北天门431700

出　　处：《临床消化病杂志》2024年第2期105-108,共4页Chinese Journal of Clinical Gastroenterology

基　　金：湖北省卫生健康委科研项目-新型10-羟基喜树碱多功能纳米药物制剂的制备及其应用于结肠癌的治疗研究(No:WJ2019 H169)。

摘　　要：[目的]比较经内镜痔上直肠黏膜套扎(super-hemorrhoidal banding,SHB)与痔核套扎治疗内痔出血的疗效及安全性。[方法]将126例患者随机分为治疗组及对照组。治疗组60例,给予SHB治疗;对照组66例,给予痔核套扎治疗。比较2组止血的成功率、再出血发生率及并发症发生率。[结果]治疗组止血成功率为100.0%,对照组止血成功率98.5%,2组比较差异无统计学意义(P>0.05);治疗组再出血率为20.0%,显著高于对照组的7.7%(P<0.05);治疗组疼痛发生率56.7%、坠胀感发生率21.7%,均显著低于对照组的100.0%、87.7%(P<0.01);治疗组术后疼痛程度明显轻于对照组(P<0.01);治疗组术后2周内大便带血率6.7%、控便异常率为0、尿潴留发生率1.7%,均低于对照组的23.1%、6.2%、7.7%,但2组比较差异无统计学意义(P>0.05);2组均未发生血栓痔。[结论]SHB与痔核套扎治疗内痔出血均有很好的止血效果;SHB术后再出血率高于痔核套扎,术后并发症少于且轻于痔核套扎。[Objective]To compare the efficacy and safety of super-hemorrhoidal banding(SHB)and hemorrhoid ligation in the treatment of internal hemorrhoid bleeding.[Methods]The totals of 126 patients were randomly divided into a treatment group and a control group,with 60 patients in the treatment group receiving SHB treatment and 66 patients in the control group treated with hemorrhoid ligation.The success rate of hemostasis,incidence of rebleeding,and incidence of complications between the two groups were compared.[Results]The success rate of hemostasis in the treatment group was 100%,while the success rate of hemostasis in the control group was 98.5%.There was no statistically significant difference between the two groups.The rebleeding rate in the treatment group was 20.0%,significantly higher than 7.7%in the control group(P<0.05).The incidence of pain and bloating in the treatment group was56.7%and 21.7%,significantly lower than 100.0%and 87.7%in the control group(P<0.01).The rate of bloody stool,abnormal stool control and urinary retention in the treatment group were 6.7%,0%,and 1.7%respectively,which was lower than those in the control group(23.1%,6.2%,and 7.7%),but there was no significant difference(P>0.05).Both groups did not experience thrombotic hemorrhoids.[Conclusion]SHB and hemorrhoid ligation for internal hemorrhoid bleeding have good hemostatic effect.The postoperative rebleeding rate of SHB is higher than that of hemorrhoid ligation,and the postoperative complications are less than that of hemorrhoid ligation.

关 键 词：痔核 痔上直肠黏膜套扎 痔核套扎 

分 类 号：R657.18[医药卫生—外科学]