内镜下橡皮圈套扎术与经典外科手术吻合器痔上黏膜环切钉合术治疗痔疮的临床疗效

Clinical efficacy of endoscopic rubber band ligation and classic surgical stapler for the treatment of hemorrhoids

摘要:

目的 对比研究内镜下橡皮圈套扎术（ERBL）与经典外科手术吻合器痔上黏膜环切钉合术（PPH）治疗痔疮的临床疗效。方法 选取2018年1月－2020年1月在淮安市第二人民医院消化内科及胃肠外科住院，分别行ERBL及PPH的Ⅱ度和Ⅲ度痔疮患者各40例。观察组为ERBL手术患者，对照组为PPH手术患者，比较两组患者的手术时间、术中出血量、术后住院天数、术后早期和晚期并发症以及治疗效果。同时比较ERBL组套扎环数量与套扎早期和晚期并发症的相关性。结果 ERBL组手术时间及术后住院时间明显短于PPH组，术中出血量明显少于PPH组，差异有统计学意义（均P = 0.000）；ERBL组术后早期并发症中疼痛及里急后重的发生率明显低于PPH组（P = 0.004和P = 0.044）；两组患者治疗总有效率比较，差异无统计学意义（χ² = 0.26，P = 0.608）。不同套扎环数量与ERBL术后早期及晚期并发症的发生无明显相关性（P > 0.05）。结论 ERBL及PPH治疗痔疮的总有效率相仿，但EBRL组手术时间及术后住院天数明显短于PPH组，术中出血量明显少于PPH组，且不同套扎环数量对ERBL术后早期及晚期并发症的发生无明显影响，ERBL用于治疗痔疮安全、有效，可应用于临床。

Abstract:

Objective To compare the clinical efficacy of endoscopic rubber band ligation (ERBL) and classic surgical stapler procedure for prolapse and hemorrhoids (PPH) in the treatment of hemorrhoids.Methods 40 hemorrhoid patients (degrees Ⅱ and Ⅲ) from January 2018 to January 2020 who underwent ERBL and PPH were selected respectively. The observation group was ERBL patients, and the control group was PPH patients. The operation time, intraoperative blood loss, postoperative hospital stay, early and late postoperative complications, and treatment effects were compared between the two groups. At the same time, the correlation between the number of ligation loops in the ERBL group and the occurrence of early and late complications of ligation was compared.Results The operation time, intraoperative blood loss and postoperative hospital stay in the ERBL group were significantly less than those in the control group (PPH group), and the difference was statistically significant (P = 0.000); The incidence of early postoperative complications, pain and tenesmus in the ERBL group were significantly lower those in the PPH group (P = 0.004, P = 0.044), but the total effective rate difference between the two groups was not statistically significant (χ² = 0.26, P = 0.608). There was no significant difference between the number of ligation rings and the early and late complications (P > 0.05).Conclusion The total effective rate of ERBL and PPH in the treatment of hemorrhoids is similar. The operation time, intraoperative blood loss and postoperative hospital stay in the EBRL group are significantly less than those in the PPH group. The number of different ligation rings has no significant effect on the incidence of early and late complications after ERBL. It is safe and effective in the treatment of hemorrhoids, and can be used in clinic.