经血管超选择直肠上动脉栓塞治疗痔病的初步临床分析

Preliminavy clinical study of the treatment of hemorrhoids by superselective embolization of superior rectal artery

目的探讨经血管超选择直肠上动脉（SRA）栓塞治疗痔病的安全性和可行性。 方法收集上海中医药大学附属曙光临床医学院2014年7月—2016年8月经血管超选择SRA栓塞的15例Ⅱ～Ⅳ度痔病患者的临床资料。依据SRA在齿线附近的分支数量和形态分别选用弹簧圈、PVA颗粒、明胶海绵颗粒、无水乙醇以及白芨胶加明胶海绵颗粒进行栓塞治疗，并观察术中操作、术后并发症以及随访治疗情况。 结果介入操作成功15例，手术时间（30±14）min，术后住院天数1～7（2.0±1.8） d，术后12 h恢复正常生活。急便感（14/15）、疼痛（5/15）、低热（11/15）均无需特殊处理即可以得到缓解。随访（19.0±2.6）个月，出血症状全部治愈，无严重并发症。 结论经血管超选择SRA栓塞治疗痔病在技术上安全可行。

ObjectiveTo investigate the safety and feasibility of the treatment of hemorrhoids by superselective arterial embolization. MethodsThe clinical data of 15 patients with grade Ⅱ to Ⅳ hemorrhoids were collected who were treated by superselective SRA embolization.According to the number and shape of SRA in the vicinity of the dentate line, chosed coils, PVA particles and gelfoam particles, ethanol and bletilla mixture of gelfoam particles for embolization.And intraoperative operations, postoperative complications, follow-up treatment results were observed. ResultsThe interventional procedures were successfully accomplished in all 15 cases.The operation time was （30±14） min, and the hospital stay was 1-7 （2.0±1.8） days after operation, and the patients recovered to normal life in 12 hours after the operation.Tenesmus （14/15）, pain （5/15） and low fever （11/15） can alleviate without special treatment. All patients were follow up （19.0±2.6） months, bleeding symptoms were cured, there′s no serious complications. ConclusionThe treatment of hemorrhoids by transcatheter superselective embolization of superior rectal artery is technically safe and feasible.