内镜下硬化术与吻合器痔上黏膜环切术治疗内痔的对比研究

Comparison of endoscopic sclerotherapy and procedure for prolapse and hemorrhoids in treatment of internal hemorrhoids

摘要:

目的 研究内镜下硬化术与吻合器痔上黏膜环切术（PPH）治疗内痔的疗效和安全性。方法 选取2015年3月－2020年8月九江市第一人民医院收治的100例内痔患者作为研究对象，分别采用结肠镜下聚桂醇注射术和PPH治疗，随访6个月，观察两组症状改善、术后并发症、有效率、平均住院天数及费用等情况。结果 硬化组治疗总有效率为94.0%，PPH组治疗总有效率为88.0%，两组比较，差异无统计学意义（P > 0.05）。硬化组平均住院时间、住院费用、患者满意度明显优于对照组，术后疼痛评分明显低于PPH组，差异均有统计学意义（P < 0.05）。硬化组并发症总发生率为8.0%，明显低于PPH组的32.0%，差异有统计学意义（P < 0.05）。结论 内痔内镜下硬化术操作简单，恢复快，安全有效，值得临床推广应用。

Abstract:

Objective To study the efficacy and safety of endoscopic sclerotherapy and prolapse and hemorrhoidectomy (PPH) in treatment of internal hemorrhoids.Methods Medical records of 100 patients with internal hemorrhoids from March 2015 to August 2020 were retrospectively screened. According to the different groups, they were treated with Lauromacrogol injection under colonoscopy, and the PPH group was treated with stapled prolapse and hemorrhoid circumcision, respectively. Over the following 6 months, the clinical efficacy, postoperative complications, recurrence rate, average length of stay and cost were observed between the two groups.Results The total effective rate of treatment was 94.0% and 88.0% respectively, in the sclerotherapy group and in the PPH group. There was no statistically significant difference between the two groups (P > 0.05). The sclerotherapy group's average stays and expenses of hospitalization, and patient satisfaction were significantly better than those of the PPH group, and the postoperative pain was significantly less than that of the PPH group. The differences were statistically significant (P < 0.05). The total incidences of complications in the sclerotherapy group were 8.0%, which was significantly less than the 32.0% in the PPH group. There was statistically difference in the complication (P < 0.05).Conclusion Endoscopic sclerosing agent injection for internal hemorrhoids is simple to operate, quick to recover, safe, effective and worthy of clinical application.