三种内镜下微创治疗内痔的疗效比较及安全性评价  

Efficacy and safety evaluation of three kinds of minimally invasive endoscopic treatment for internal hemorrhoids

作　　者：吴世民 于芳芳 张丽娅 陈坚强 项利娟 WU Shimin;YU Fangfang;ZHANG Liya;CHEN Jianqiang;XIANG Lijuan(Department of Gastroenterology,Shangyu People’s Hospital of Shaoxing,Shaoxing 312300,Zhejiang,China)

机构地区：[1]绍兴市上虞人民医院消化内科,浙江绍兴312300

出　　处：《中国现代医生》2024年第28期6-9,共4页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2024ZL181);绍兴市卫生健康科技计划(2023SKY113)。

摘　　要：目的比较三种内镜下微创治疗内痔的疗效及安全性。方法回顾性分析2020年1月至2023年6月于绍兴市上虞人民医院行内镜治疗的222例内痔患者的临床资料,根据治疗方法将其分为单纯硬化组(40例)、单纯套扎组(114例)和联合组(68例),比较三组患者的围手术期指标、术后不良事件、有效率和满意度。结果三组患者的手术操作时间比较差异有统计学意义(P<0.05),单纯套扎组手术操作时间最短。三组患者的术后住院时间比较差异无统计学意义(P>0.05)。单纯套扎组和联合组患者的肛门坠胀感、术后疼痛和排尿困难发生率显著高于单纯硬化组(P<0.05);单纯套扎组患者的术后出血发生率显著高于单纯硬化组和联合组(P<0.05)。三组患者的治疗有效率比较差异有统计学意义(P<0.05),联合治疗效果最佳。三组患者的满意度均较高,比较差异无统计学意义(P>0.05)。结论三种内镜下微创治疗内痔的方法均安全有效,套扎联合硬化治疗可有效改善症状,术后迟发性出血率低,是一种安全高效的治疗方法。Objective To compare the efficacy and safety of three kinds of endoscopic minimally invasive treatment of internal hemorrhoids.Methods The clinical data of 222 patients with internal hemorrhoids who underwent endoscopic treatment in Shangyu People’s Hospital of Shaoxing from January 2020 to June 2023 were retrospectively analyzed.According to the treatment method,the patients were divided into simple sclerotherapy group(40 cases),simple ligation group(114 cases)and combined group(68 cases).The perioperative indexes,postoperative adverse events,effective rate and satisfaction of three groups were compared.Results There was significant difference in operation time among three groups(P<0.05),and the operation time of simple ligation group was the shortest.There was no significant difference in postoperative hospital stay among three groups(P>0.05).The incidences of anal distention,postoperative pain and dysuria in simple ligation group and combined group were significantly higher than those in simple sclerotherapy group(P<0.05).The incidence of postoperative bleeding in simple ligation group was significantly higher than that in simple sclerotherapy group and combined group(P<0.05).There was significant difference in treatment effectiveness among three groups(P<0.05),and combined treatment had the best effect.The satisfaction of three groups was higher,and the difference was not statistically significant(P>0.05).Conclusion The three endoscopic minimally invasive treatment methods for internal hemorrhoids are safe and effective.Ligation combined with sclerotherapy can effectively improve symptoms,and the postoperative delayed bleeding are low,which is a safe and efficient treatment method.

关 键 词：内痔 内镜下硬化治疗 内镜下套扎治疗 套扎联合硬化治疗 并发症 疗效 

分 类 号：R657.18[医药卫生—外科学]