内镜下串联套扎术与痔核套扎术治疗内痔的效果比较

Comparison of the effect between endoscopic tandem ligation and hemorrhoid ligation in the treatment of internal hemorrhoids

摘要:

目的 比较内镜下串联套扎术与痔核套扎术治疗内痔的疗效和并发症。方法 回顾性分析2021年11月－2023年3月该院消化内科因便血住院治疗的120例Ⅰ～Ⅲ度内痔患者的临床资料。根据手术方式的不同，将接受内镜下痔核套扎术治疗的60例患者分为对照组；将接受内镜下串联套扎术治疗的60例患者分为治疗组。比较两组患者术后6个月内痔出血的治疗有效率、内痔脱垂疗效和术后并发症发生率。结果 治疗组与对照组内痔出血的治疗有效率均为100.00%；治疗组治疗Ⅱ度内痔脱垂的疗效与对照组相当，差异无统计学意义（P > 0.05），但治疗组治疗Ⅲ度内痔脱垂的疗效明显优于对照组，差异有统计学意义（P < 0.01）；治疗组术后肛门坠胀感的发生率高于对照组，差异有统计学意义（P < 0.05）；两组患者术后肛周疼痛、尿潴留和控便异常等并发症发生率比较，差异均无统计学意义（P > 0.05），两组患者术后均未发生血栓性外痔等。结论 内镜下串联套扎术与痔核套扎术治疗内痔出血的近期疗效相似，均能取得理想效果；两者治疗Ⅱ度内痔脱垂的近期疗效相似；内镜下串联套扎术治疗Ⅲ度内痔脱垂的近期疗效明显优于痔核套扎术；治疗组术后肛门坠胀感发生率高于对照组，其余并发症无明显差别。

Abstract:

Objective To investigate the clinical effects and complications of endoscopic tandem ligation and hemorrhoids ligation.Methods Clinical data of 120 patients with grade I~III internal hemorrhoids who were hospitalized due to hematochezia from November 2021 to March 2023 were retrospectively analyzed. According to the different surgical methods, 60 patients who received endoscopic hemorrhoid ligation were divided into control group; 60 patients who underwent endoscopic tandem ligation were divided into treatment group. The effective rate of hemorrhoidal hemorrhage, the effect of internal hemorrhoidal prolapse and the incidence of postoperative complications were compared between two groups within 6 months after operation.Results The effective rate of internal hemorrhoidal bleeding was 100.00% in both groups, and the efficacy of the treatment group in the treatment of degree Ⅱ internal hemorrhoidal prolapse was similar to that in the control group (P > 0.05), but the treatment group was significantly better than the control group in the treatment of degree Ⅲ internal hemorrhoidal prolapse(P < 0.01), the postoperative anal pain in the treatment group was significantly more than the control group (P < 0.05); There were no significant differences in postoperative perianal pain, urinary retention, and abnormal defecation between the two groups (P > 0.05). No thrombotic external hemorrhoids occured in two groups.Conclusion The short-term efficacy of endoscopic tandem ligation and hemorrhoidal ligation in the treatment of internal hemorrhoidal bleeding is similar and both achieved satisfactory results, the short-term efficacy of the two in the treatment of degree Ⅱ internal hemorrhoidal prolapse is similar, the short-term efficacy of the former in the treatment of degree Ⅲ internal hemorrhoidal prolapse is significantly better, the feeling of anal heaviness in the treatment group is more than that in the control group, and there is no striking difference in the other complications.