超选择动脉栓塞治疗内痔11例临床效果

Super-selective arterial embolization for the treatment of internal hemorrhoids: clinical results in 11 patients

目的评价超选择动脉栓塞术治疗内痔的临床效果。方法回顾性分析2016年4月至2017年7月苏州大学附属第二医院采用超选择直肠上动脉(SRA)栓塞术治疗11例Ⅱ~Ⅲ度内痔患者临床资料。选择微弹簧圈结合明胶海绵颗粒进行栓塞。分析手术疗效、并发症及随访结果。结果 11例患者手术均获成功。其中2例伴有阴部内动脉分支供血,行靶血管栓塞。手术用时30~40 min,平均(35.9±4.3)min;住院1~3 d,平均(1.8±0.7)d。所有患者均无感染、穿孔等并发症发生,术后疼痛(1/11)、里急后重(2/11)均可缓解,不需特殊治疗。定期复查超声显示痔核基本缩小,内部血流缓慢,便血症状明显改善。结论超选择动脉栓塞术治疗Ⅱ~Ⅲ度内痔安全可行。

Objective To evaluate the clinical efficacy of super-selective arterial embolization in treating internal hemorrhoids. Methods The clinical data of 11 patients with grade Ⅱ-Ⅲ internal hemorrhoids, who received super-selective embolization of the superior rectal artery（SRA） during the period from April 2016 to July 2017 at the Second Affiliated Hospital of Soochow University, China, were retrospectively analyzed. Micro spring coils and gelfoam particles were used for embolization. The surgical effect, complications and follow-up results were analyzed. Results The technical success rate was 100%. In2 patients, the internal hemorrhoids got the blood supply also from internal pudendal artery and the embolization of these target vessels was adopted. The time spent in surgery was 30-40 min with a mean of（35.9±4.3） min. The hospitalization time ranged from one to 3 days with an average of（1.8±0.7） days. No serious complications such as infection or perforation occurred in all patients. Mild complications included postoperative pain（n=1） and tenesmus（n=2）, which could be relieved by itself and no special treatment was needed. Regular check-up with ultrasound showed that the hemorrhoids basically shrank, its internal blood flow was slow, and the symptom of hematochezia was obviously improved. Conclusion For the treatment of grade Ⅱ-Ⅲ internal hemorrhoids, super-selective arterial embolization is clinically safe and feasible.