内镜下套扎手术和外科痔切除术治疗内痔的临床价值比较

Clinical value comparison between endoscopic ligation surgery and surgical hemorrhoidectomy for internal hemorrhoids

摘要:

目的 比较内镜下套扎手术与外科痔切除术对内痔的治疗价值。方法 选择2023年2月－2025年4月该院收治的340例内痔患者，根据治疗方法分为两组，行外科痔切除术的160例患者为对照组，行内镜下套扎手术的180例患者为观察组，比较两组患者手术相关指标，评估术后肛门疼痛情况，检测手术前后血清炎症因子、肛门功能、肛肠动力学指标和肛门狭窄程度，统计并发症情况。结果 观察组手术时间明显短于对照组，术中出血量明显少于对照组，治疗费用明显低于对照组，差异均有统计学意义（P < 0.05）。术后1和7 d，观察组疼痛视觉模拟评分法（VAS）评分明显低于对照组，差异有统计学意义（P < 0.05）；术后1个月，观察组血清炎症因子水平明显低于对照组，差异有统计学意义（P < 0.05）；术后1个月，观察组肛门功能Kelly量表评分明显高于对照组，差异有统计学意义（P < 0.05）；术后1个月，两组患者肛肠动力学指标水平比较，差异有统计学意义（P < 0.05）；观察组并发症发生率和肛门狭窄率明显较低（P < 0.05）。结论 内镜下套扎手术与外科痔切除术均可用于内痔治疗中，但与后者相比，前者在改善血清炎症因子、肛门功能、术后疼痛感方面效果更佳，还可缩短手术时间，减少术中出血量，减轻经济负担。

Abstract:

Objective To compare the therapeutic value of endoscopic ligation surgery and surgical hemorrhoidectomy for internal hemorrhoids.Methods This study was a retrospective study, selected 340 patients with internal hemorrhoids admitted to the hospital from February 2023 to April 2025. According to the treatment method, they were divided into two groups: 160 patients who underwent surgical hemorrhoidectomy as the control group and 180 patients who underwent endoscopic ligation surgery as the observation group. The surgical related indicators of the two groups were compared to evaluate postoperative anal pain, detect serum inflammatory factors, anal function, anorectal motility indicators, anal stenosis degree before and after surgery, and statistically analyze the incidence of complications.Results The observation group had a shorter surgical time, less intraoperative bleeding, and lower treatment costs compared to the control group, with statistically significant differences (P < 0.05). On the 1st and 7th day after the surgery, the pain visual analogue scale (VAS) scores of the observation group were significant lower than those of the control group, with statisticlly significant differences (P < 0.05). One month after the surgery, the levels of serum inflammatory factors in the observation group were lower than those of the control group, with statisticlly significant differences (P < 0.05). One month after the surgery, the score of the anal function Kelly scale in the observation group was higher than that of the control group, with statisticlly significant difference (P < 0.05). One month after the surgery, there were obvious differences in the levels of anorectal dynamic indicators between the two groups (P < 0.05). The incidence of complications and the rate of anal stenosis in the observation group were relatively lower (P < 0.05).Conclusion Both endoscopic ligation surgery and surgical hemorrhoidectomy can be used in the treatment of internal hemorrhoids. However, compared with the latter, the former is more effective in improving the patient's serum inflammatory factors, anal function, and postoperative pain. It can also shorten the patient's operation time, reduce the intraoperative blood loss, and relieve the patient's economic burden.