超声多普勒引导下痔动脉结扎术联合微创手术治疗重症痔疮的临床疗效观察

Clinical efficacy of ultrasonic Doppler guided hemorrhoid artery ligation combined with minimally invasive surgery in treatment of severe hemorrhoids

摘要:

摘要：目的??探究超声多普勒引导下痔动脉结扎术（DG-HAL）联合吻合器痔上黏膜环切术（PPH）治疗重症痔疮的临床疗效及安全性。方法?选择2016年1月－2017年1月于该院就诊的重症痔疮患者72例，按照随机数字表法分为对照组（n =35）与观察组（n =37），对照组患者接受PPH治疗，观察组接受DG-HAL联合PPH治疗。观察两组患者的手术相关指标、治疗效果及并发症发生率等。结果?两组患者手术时间、术中出血量无明显差异（P >0.05）。观察组术后创面愈合时间及住院时间明显短于对照组，差异有统计学意义（P <0.05）。观察组术后1个月治疗有效率为94.6%，明显高于对照组有效率77.1%，差异有统计学意义（P <0.05）。两组患者术前和术后7 d视觉模拟评分（VAS）无明显差异（P >0.05）。观察组术后14 d VAS评分明显低于对照组（P <0.05）。观察组术后3个月Wexner评分明显低于对照组，差异有统计学意义（P <0.05）。观察组并发症发生率为2.7%，明显低于对照组（P <0.05）。结论?DG-HAL联合PPH治疗重症痔疮有较好的临床疗效，手术操作简单安全，术后并发症发生率低，值得临床推广使用。

关键词:关键词： 痔疮;痔动脉结扎术;超声多普勒;吻合器痔上黏膜环切术

Abstract:

Abstract: Objective?To explore the clinical efficacy and safety of ultrasonic Doppler guided hemorrhoid artery ligation combined with minimally invasive operation (PPH) in treatment of severe hemorrhoids.?Methods?72 patients with severe hemorrhoids from January 2016 to January 2017 were randomly divided into control group (n = 35) and observation group (n = 37), the control group received PPH treatment, the observation group received ultrasound Doppler hemorrhoidal artery ligation combined with PPH therapy. The surgical indexes, therapeutic effects and incidence of complications of the two groups were observed.?Results?There was no significant difference in the time of operation and the amount of bleeding in the two groups (P > 0.05). The time of wound healing and the time of hospitalization in the observation group were significantly shorter than those in the control group, and the difference was statistically significant (P < 0.05). The effective rate of the observation group at 1 months after operation was 94.6%, obviously higher than 77.1% of the control group, the difference was statistically significant (P < 0.05). There was no significant difference in VAS score between the two groups before and at 7 days after operation (P > 0.05). The score of VAS in the observation group was significantly lower than that of the control group at 14 days after the operation (P > 0.05). The score of Wexner in the observation group was significantly lower than that of the control group at 3 months after operation, and the difference was statistically significant (P < 0.05). The incidence of complications in the observation group was 2.7%, which was significantly lower than that of the control group (P < 0.05).?Conclusion?Doppler ultrasound guided hemorrhoidal artery ligation combined with PPH has a good clinical effect in treatment of severe hemorrhoids. The operation is simple and safe, and the incidence of postoperative complications is low, so it is worthy of clinical application.

Key words:Keywords: hemorrhoids; hemorrhoid artery ligation; ultrasonic Doppler; procedure for prolapse and hemorrhoids