痔上黏膜环切钉合术与痔胶圈套扎术治疗Ⅲ度内痔疗效观察

Comparison of efficacy between procedure for prolapse and hemorrhoids and rubber band ligation in treatment of Ⅲ degree internal hemorrhoids

目的比较痔上黏膜环切钉合术（PPH）与痔胶圈套扎术（RBL）治疗Ⅲ度内痔的疗效。方法将100例Ⅲ度内痔患者随机分成PPH组（42例）和RBL组（58例），比较两组患者术后即刻、2周、2个月和6个月的疗效。结果PPH组与RBL组在控制内痔脱垂、瘙痒症状方面疗效差异无统计学意义（P〉0．05），但RBL组术后2周出血率（51．7％，30／58）高于PPH组（19．0％，8／42）（P〈0．05）；在整体满意度方面两组差异无统计学意义（P〉0．05）；在术后6个月的随访中，PPH组术后即刻、2周疼痛视觉模拟评分法评分高于RBL组（P〈0．05），PPH组并发症总发生率（16．7％，7／42）高于RBL组（0，0／58）（P〈0．05）。结论痔胶圈套扎术可以作为Ⅲ度内痔的一线治疗方法。

Objective To compare efficacy of procedure for prolapse and hemorrhoids （PPH） and rubber band ligation （RBL） in treatment of Ⅲ degree internal hemorrhoids. Methods One hundred patients with Ⅲ degree internal hemorrhoids were randomly divided into two groups and received PPH （42 cases） and RBL （58 cases） respectively. At once and after two weeks and two and six months the efficacy were compared. Results PPH and RBL were equally effective in controlling symptomatic prolapse （P 〉 0.05）, but RBL was associated with an increased incidence of recurrent bleeding （PPH 8/42 vs RBL 30/58, P 〈 0.05）;there was no difference in scores of patient satisfaction （P 〉 0.05）; PPH was associated with increased pain and analgesia usage at both at once and 2-week foUow-up （P 〈 0.05）; the rate of complications in PPH was higher than in RBL （7/42 vs 0/58,P 〈 0.05）. Conclusion RBL can be used as treatment of first-line treatment of Ⅲ degree internal hemorrhoids.