铜离子电化学疗法与选择性痔上黏膜切除钉合术治疗Ⅲ~Ⅳ度痔的效果比较  

Comparison of electrochemical therapy by Cupric ion and selective suprahemorrhoid mucosal resection and stapling surgery for the treatment of grade Ⅲ-Ⅳ hemorrhoids

作　　者：陶琦 聂龙 王宜慧 王伟民 郑武[1] TAO Qi;NIE Long;WANG Yihui;WANG Weimin;ZHENG Wu(Department of Anorectal Surgery,the People’s Hospital of Macheng,Hubei 438300,China)

机构地区：[1]湖北省麻城市人民医院肛肠外科,438300

出　　处：《临床外科杂志》2025年第2期183-186,共4页Journal of Clinical Surgery

基　　金：湖北省麻城市人民医院科技人才培养专项科研基金项目(KY-Y-2022B02)。

摘　　要：目的 比较铜离子电化学疗法与选择性痔上黏膜切除钉合术治疗Ⅲ~Ⅳ度痔的疗效。方法 2022年9月~2023年10月收治的Ⅲ~Ⅳ度混合痔病人204例,按数字法分为观察组和对照组两组,每组各102例。观察组行铜离子电化学疗法,对照组行选择性痔上黏膜切除钉合术。比较两组手术相关情况、临床疗效、疼痛评分、肛门功能评分、生活质量指数评分及并发症发生率。结果 观察组与对照组的性别、年龄、痔分度、手术时间、住院时间比较差异无统计学意义(P>0.05),但观察组术中出血量少于对照组[(11.37±5.32)ml和(26.72±14.24)ml],两组比较差异有统计学意义(P<0.05);观察组术后1天、7天疼痛严重程度低于对照组,差异有统计学意义(P<0.05);两组术后1周、8周Wexner肛门失禁评分差异无统计学意义(P>0.05),观察组术后2周胃肠道生活质量指数(GIQLI)评分优于对照组[(20.92±4.63)分和(26.77±5.03)分,P<0.05],两组术后8周比较差异无统计学意义[(4.38±0.90)分和(4.68±1.41)分,P>0.05];观察组和对照组术后并发症总的发生率分别为8.8%和20.6%,差异有统计学意义(P<0.05)。平均随访6个月,均无复发。结论 铜离子电化学疗法治疗Ⅲ~Ⅳ度混合痔安全、有效、无严重并发症,提供了一种更简便、微创的治疗方法。Objective To compare the efficacy and complications of cupric ion electrochemical therapy and selective suprahemorrhoid resection and stapling surgery for the treatment of gradeⅢ-Ⅳhemorrhoids.Methods 204 patients with gradeⅢ-Ⅳmixed hemorrhoids admitted to our hospital from September 2022 to October 2023 were included as the study subjects.They were divided into two groups using numerical method,with 102 cases in each group.The observation group received copper ion electrochemical therapy,while the control group received selective hemorrhoid mucosal resection and stapling surgery.Compare the surgical outcomes,efficacy,pain scores,anal function scores,quality of life index scores,and incidence of complications between two groups.Results There was no statistically significant difference in gender,age,hemorrhoid grade,surgical time,and hospitalization period between the observation group and the control group(P>0.05),but the intraoperative blood loss in the observation group was less than that in the control group[(11.37±5.32)ml and(26.72±14.24)ml],and the difference between the two groups was statistically significant(P<0.05).The severity of pain in the observation group was lower than that in the control group on the 1st and 7th day after surgery(P<0.05);There was no statistically significant difference in the Wexner anal incontinence scores between the two groups at 1 and 8 weeks after surgery(P>0.05).The observation group had a better gastrointestinal quality of life index(GIQLI)score than the control group at 2 weeks after surgery[(20.92±4.63)and(26.77±5.03)scores,P<0.05],and there was no statistically significant difference between the two groups at 8 weeks[(4.38±0.90)and(4.68±1.41)mm,P>0.05].The total incidence of postoperative complications in both groups was statistically significant(8.8%vs 20.6%,P<0.05).An average follow-up of six months showed no recurrence.Conclusion Cupric ion electrochemical therapy for mixed hemorrhoids is safe,effective,and has no serious complications,providing a more c

关 键 词：混合痔 铜离子电化学疗法 选择性痔上黏膜切除钉合术 并发症 

分 类 号：R65[医药卫生—外科学]