Comparison of efficacy of vascular embolizationand endoscopy combined with lauromacrogolin treatment of hemorrhoid hemorrhage
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摘要:目的 比较血管栓塞介入与软式内镜联合聚桂醇治疗内痔出血的疗效。方法 选取103例Ⅰ~Ⅱ期内痔出血患者，根据治疗方式不同分为硬化疗法组55例和介入疗法组48例。硬化疗法组给予软式内镜联合聚桂醇注射硬化疗法治疗，介入疗法组给予血管栓塞介入疗法治疗。分析2组患者手术、术后恢复相关指标；评估2组治疗效果。结果 介入疗法组手术需要时间、创面愈合时间及住院时间短于硬化疗法组，术中出血量少于硬化疗法组，肛门失禁、肛缘水肿、疼痛、出血评分均低于硬化疗法组，差异有统计学意义（P < 0.05）。介入疗法组无痛患者占比、治疗总有效率高于硬化疗法组，中度疼痛占比、并发症总发生率低于硬化疗法组，差异有统计学意义（P < 0.05）。结论 与软式内镜联合聚桂醇注射硬化疗法相比，血管栓塞介入治疗Ⅰ~Ⅱ期内痔出血患者疗效更佳，可减轻患者术后疼痛，减少并发症发生。Abstract:Objective To compare the efficacy of vascular embolization and soft endoscopy combined with lauromacrol in treatment of hemorrhoid hemorrhage.Methods A total of 103 patients with hemorrhoid hemorrhage at stage Ⅰ to Ⅱ were selected and divided into sclerotherapy group (n=55) and interventional therapy group (n=48) according to different treatment methods. The sclerotherapy group was treated with soft endoscope combined with lauromacrol injection sclerotherapy, and the interventional therapy group was treated with vascular embolization interventional therapy. The indexes related to operation and postoperative recovery in two groups were analyzed; the therapeutic effect of the two groups was evaluated.Results The operation time, wound healing time and hospital stay time of the interventional therapy group were significantly shorter; the amount of intraoperative blood loss was significantly less; the scores of anal incontinence, anal edema, pain and bleeding were significantly lower than those in the sclerotherapy group (P < 0.05). The proportion of painless patients and total effective rate in the interventional therapy group were significantly higher; the proportion of moderate pain and total incidence of complications in the sclerotherapy group were significantly lower than those in sclerotherapy group (P < 0.05).Conclusion Compared with soft endoscopy combined with lauromacrogol injection sclerosis therapy, vascular embolization in treatment of stage Ⅰ to Ⅱ internal hemorrhoid hemorrhage patients has better efficacy, which can relieve postoperative pain, reduce the incidence of complications.
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Keywords:
- vascular embolism /
- endoscope /
- lauromacrogol /
- sclerosis /
- hemorrhage of internal hemorrhoid
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表 1 2组患者一般资料比较(x±s)[n(%)]
一般资料 硬化疗法组(n=55) 介入疗法组(n=48) χ2/t P 年龄/岁 40.38±19.25 40.31±19.20 0.020 0.985 病程/年 5.23±4.00 5.20±3.95 0.040 0.969 性别 男 28(50.91) 25(52.08) 0.014 0.905 女 27(49.09) 23(47.92) 痔疮分期 Ⅰ期 29(52.73) 26(54.17) 0.021 0.884 Ⅱ期 26(47.27) 22(45.83) 临床症状 疼痛 45(81.82) 38(79.17) 0.260 0.878 脱出 15(27.27) 10(20.83) 贫血 5(9.09) 4(8.33) 
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表 2 2组患者手术相关指标比较(x±s)
组别 n 手术需要时间/min 术中出血量/mL 创面愈合时间/d 住院时间/d 硬化疗法组 55 18.87±3.38 7.78±1.85 15.59±3.87 10.22±2.57 介入疗法组 48 16.45±3.25* 5.62±1.23* 13.50±3.60* 8.62±2.15* 与硬化疗法组比较, *P < 0.05。
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表 3 2组患者术后各项肛门症状评分比较(x±s)
分 组别 n 肛门失禁 肛缘水肿 疼痛 出血 硬化疗法组 55 0.57±0.15 0.60±0.18 5.05±1.15 0.66±0.20 介入疗法组 48 0.44±0.05* 0.36±0.11* 3.20±0.25* 0.53±0.17* 与硬化疗法组比较, *P < 0.05。
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表 4 2组患者术后肛门疼痛程度比较[n(%)]
组别 n 无痛 轻微疼痛 中度疼痛 剧烈疼痛 硬化疗法组 55 15(27.27) 27(49.09) 10(18.18) 3(5.45) 介入疗法组 48 28(58.33)* 18(37.50) 2(4.17)* 0 与硬化疗法组比较, *P < 0.05。
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