多普勒超声引导下痔动脉结扎加外剥内扎术在痔手术中的应用

Doppler Guided Hemorrhoidal Artery Ligation Plus External Dissection and Internal Ligation in Treatment of Hemorrhoids

为探讨多普勒超声引导下痔动脉结扎术（DG-HAL）加外剥内扎术治疗痔的临床疗效及安全性，将219例混合痔患者随机分为3组，每组73例。治疗组采用DG-HAL加外剥内扎术治疗，外剥内扎术组采用外剥内扎术治疗，DG-HAL组采用DG-HAL治疗。分别观察3组术后的疼痛评分、术后并发症及肛门功能等指标。结果显示，在疼痛评分方面DG-HAL组优于治疗组和外剥内扎术组，治疗组在术后出血、赘皮残留以及内痔复发方面均优于其它两组。在术后肛门功能方面治疗组和DG-HAL组均优于外剥内扎术组。结果表明，DG-HAL加外剥内扎术治疗混合痔，疗效确切，不良反应少，而且能减少术后出血、赘皮残留以及内痔复发等并发症和后遗症。

In order to discuss the clinical efficacy and safety of Doppler guided hemorrhoidal artery ligation （DG-HAL） plus external dissection and internal ligation in treatment of hemorrhoids,219 cases of mixed hemorrhoids were randomized into 3 groups, 73 cases for each group. Treatment group underwent DG-HAL plus external dissection and internal ligation,external dissection and internal ligation group received external dissection and internal ligation,DG-HAL group received DG-HAL. All three groups were observed for postoperative pain score, complications and anal function. The results showed that DG-HAL group was superior to the other two groups in pain scores,and treatment group was superior to the other two groups in postoperative bleeding, residual hemorrhoid skin tags, recurrence of internal hemorrhoids. Treatment group and DG-HAL group were superior to external dissection and internal ligation group in postoperative anal function. It is concluded that DG-HAL plus external dissection and internal ligation is of certain effect for mixed hemorrhoids, and has fewer adverse reactions, and can reduce postoperative bleeding, residual hemorrhoid skin tags, recurrence of internal hemorrhoids as well other complications or sequelae.