体表标记定位下内镜套扎治疗Ⅱ~Ⅲ度内痔的前瞻性研究

doi:10.3969/j.issn.1009-976X.2022.02.013

摘要/Abstract

摘要： 目的探讨体表标记定位内镜下内痔套扎治疗Ⅱ~Ⅲ度内痔的临床效果。方法将70例Ⅱ~Ⅲ度内痔患者分成观察组和对照组,分别为35例。观察组采用精准体表定位内镜下痔套扎术治疗,对照组采用传统痔套扎术。比较两组患者术后疼痛、出血等并发症、临床效果等指标。结果观察组和对照组的年龄、性别、痔分度等一般临床资料差异无统计学意义。观察组和对照组手术时间、术后出血发生率差异无统计学意义（P>0.05）。观察组术后疼痛视觉评分低于对照组,生活质量评分优于对照组,差异具有统计学意义（P<0.05）,观察组总体有效率97.14%,高于对照组的85.71%,并发症发生率5.71%,低于照组的17.14%,差异无统计学意义（P>0.05）。结论体表精准定位内镜下痔套扎治疗Ⅱ~Ⅲ度内痔疗效确切,较传统痔套扎术疼痛更轻、并发症更少。

关键词: 内痔, 内镜套扎, 疼痛评分, 生活质量, 并发症

Abstract: Objective This study accessed the clinical efficacy of skin location assisted endoscopic band ligation for grade Ⅱ-Ⅲ internal hemorrhoids. Methods A total of 70 consecutive patients diagnosed grate Ⅱ-Ⅲ internal hemorrhoids were enrolled in this study. The observation group（n=35） performed skin location assisted endoscopic band ligation and the control group（n=35） performed tradition hemorrhoids ligation. The age, gender and the classification of hemorrhoids for both groups were of no significant differences. The post operational pain, bleeding, other complications and effectiveness were observed and compared. Results The operative time and postoperative bleeding rate for both groups were of no significant difference. The post operational pain of the observation group was significantly lower than that of the control group, and the life quality for the observation group was significantly greater than that of the control group. The observation group had greater effective rate （97.14% vs 85.71%, P>0.05）, and fewer complication rate than the control group （5.71% vs 17.14%, P>0.05）but had no significant difference. Conclusions Skin location assisted EBL causes less postoperative pain and less complication than the traditional ligation group and is expected to be safe and effective for grade Ⅱ-Ⅲ internal hemorrhoids.

Key words: internal hemorrhoids, endoscopic rubber band ligation, visual analogue scale, life quality, complication

中图分类号:

R657.1

黎淑玲, 刘俊杰. 体表标记定位下内镜套扎治疗Ⅱ~Ⅲ度内痔的前瞻性研究[J]. 岭南现代临床外科, 2022, 22(02): 187-190.

LI Shu-ling, LIU Jun-jie. A prospective study of skin location assisted endoscopic band ligation for grade Ⅱ-Ⅲ internal hemorrhoids[J]. Lingnan Modern Clinics In Surgery, 2022, 22(02): 187-190.

参考文献

[1] Ma W, Guo J, Yang F, et al.Progress in Endoscopic Treatment of Hemorrhoids[J]. J Transl Int Med, 2020, 8(4): 237-244.
[2] Cocorullo G, Tutino R, Falco N, et al.The non-surgical management for hemorrhoidal disease. A systematic review[J]. G Chir, 2017,38(1): 5-14.
[3] 王军民, 马欢, 赵文娟, 焦黎. 内镜下套扎术治疗内痔54例前瞻性研究[J]. 中国内镜杂志, 2020, 26(4): 50-54.
[4] 中华医学会外科学分会结直肠肛门外科学组, 中华中医药学会肛肠病专业委员会, 中国中西医结合学会结直肠肛门病专业委员会. 痔临床诊治指南(2006版)[J].中华胃肠外科杂志,2006(5):461-463.
[5] Patel S, Shahzad G, Rizvon K, et al.Rectal ulcers and massive bleeding after hemorrhoidal band ligation while on aspirin[J]. World J Clin Cases, 2014, 2(4): 86-89.
[6] 戴鹏飞, 刘长宝. 小切口外痔剥离加内痔缝扎术治疗环状混合痔的临床效果[J]. 数理医药学杂志, 2021, 34(10): 1453-1456.
[7] 宋小平, 陈显韬, 闫骁春. 改良外剥内扎术治疗环状混合痔的临床疗效观察[J]. 中国现代医学杂志, 2020, 30(8): 105-109.
[8] 黄玉宝, 陈至玉, 周雄. RPH与PPH分别联合外剥内扎术治疗中重度混合痔高龄患者的手术分析 [J]. 岭南现代临床外科, 2020, 20(4): 448-451+455.
[9] Lohsiriwat V.Treatment of hemorrhoids: A coloproctologist's view[J]. World J Gastroenterol, 2015, 21(31):9245-52.
[10] Awad AE, Soliman HH, Saif SA, et al.A prospective randomised comparative study of endoscopic band ligation versus injection sclerotherapy of bleeding internal haemorrhoids in patients with liver cirrhosis[J]. Arab J Gastroenterol, 2012, 13(2): 77-81.
[11] Su MY, Chiu CT, Lin WP, et al.Long-term outcome and efficacy of endoscopic hemorrhoid ligation for symptomatic internal hemorrhoids[J]. World J Gastroenterol, 2011, 17(19): 2431-2436.
[12] Schleinstein HP, Averbach M, Averbach P, et al.Endoscopic band ligation for the treatment of hemorrhoidal disease[J]. Arq Gastroenterol, 2019, 56(1): 22-27.
[13] Abiodun AA, Alatise OI, Okereke CE, et al.Comparative study of endoscopic band ligation versus injection sclerotherapy with 50% dextrose in water, in symptomatic internal haemorrhoids[J]. Niger Postgrad Med J, 2020, 27(1): 13-20.
[14] Hollingshead JR, Phillips RK.Haemorrhoids: modern diagnosis and treatment[J]. Postgrad Med J, 2016, 92(1083): 4-8.
[15] Albuquerque A.Rubber band ligation of hemorrhoids: A guide for complications[J]. World J Gastrointest Surg, 2016, 8(9): 614-620.