手法按摩在内镜下泡沫硬化剂注射治疗Ⅰ度出血性内痔中的价值

Clinical value of manual massage in treatment of grade I internal hemorrhoids under endoscopic foam sclerotherapy

摘要:

目的 评价手法按摩对内镜下泡沫硬化剂注射治疗Ⅰ度内痔术后并发症的影响。方法 前瞻性纳入连续就诊的Ⅰ度内痔患者133例，完成内镜下泡沫硬化剂注射治疗。术后随机分为按摩组（n = 65）和对照组（n = 68），按摩组行肛周手法按摩。采用视觉模拟评分法（VAS）评价术后肛周疼痛情况，比较术后出血情况、短期疗效和长期疗效。结果 按摩组，术后24 h VAS为1.0（0.0，3.0）分，明显低于对照组的2.0（1.0，4.0）分，差异有统计学意义（P = 0.014）；按摩组术后1周未出血者占84.6%，明显高于对照组的64.7%，差异有统计学意义（P = 0.009）。术后12周、6个月和12个月，两组患者短期治愈率和长期治愈率比较，差异均无统计学意义（P > 0.05）。结论 内镜下泡沫硬化剂注射后行手法按摩，有利于缓解Ⅰ度内痔术后疼痛，减少出血。

Abstract:

Objective To evaluate the effect of manual massage on complications after endoscopic foam sclerotherapy injection for the treatment of internal hemorrhoids.Methods Consecutive 113 patients with grade Ⅰ internal hemorrhoids were prospectively enrolled and completed endoscopic foam sclerotherapy. The patients were randomly divided into a massage group (n = 65) and a control group (n = 68). Massage group performed manual perianal massage, Visual analogue scale (VAS) was used to evaluate perianal pain. The postoperative bleeding, short-term and long-term efficacy were also compared.Results The median VAS of 24 h postoperation was 1.0 (0.0, 3.0) in massage group, which was significantly lower than 2.0 (1.0, 4.0) in control group, the difference was statistically significant (P = 0.014). The no bleeding rate of one week postoperation was 84.6% in massage group, which was significantly higher than 64.7% in control group, the difference was statistically significant (P = 0.009). After 12 weeks, 6 months and 12 months of follow-up, there were no significant differences in cure rate and remission rate between the two groups (P > 0.05).Conclusion Manual massage after endoscopic sclerosing agent injection is beneficial to relieve postoperative pain of grade I internal hemorrhoids and reduce bleeding.