胶圈套扎联合痔动脉结扎术治疗出血性内痔伴出血倾向患者的疗效观察

Effect of rubber band ligation combined with hemorrhoidal artery ligation in treating bleeding internal hemorrhoids with hemorrhagic tendency

目的探讨胶圈套扎联合痔动脉结扎术治疗出血性内痔伴出血倾向患者的临床疗效。方法纳入2015年3月至2016年10月于上海中医药大学附属市中医医院住院的60例出血性内痔伴出血倾向患者为研究对象,随机分为观察组和对照组,每组各30例。观察组采用胶圈套扎术联合痔动脉结扎术,对照组采用硬化剂注射术。术后评价两组临床疗效,记录两组并发症发生情况以及术后6个月内复发情况。结果观察组总体临床疗效优于对照组,差异有统计学意义(P <0.05)。两组在手术疼痛情况以及术后第2 d、7 d排便情况比较,差异均无统计学意义(均P> 0.05);观察组术后第7 d出血情况少于对照组(P <0.05)。观察组复发率低于对照组,差异有统计学意义(P <0.05)。结论与硬化剂注射术相比,胶圈套扎术联合痔动脉结扎治疗出血性内痔伴出血倾向患者疗效更优、术后复发率更低,且安全性良好。

Objectives To investigate the effect of rubber band ligation combined with hemorrhoidal artery ligation in patients with bleeding internal hemorrhoids with hemorrhagic tendency. Methods 60 patients with bleeding internal hemorrhoids with hemorrhagic tendency hospitalized at Shanghai Municipal Hospital of Traditional Chinese Medicine, Affiliated Hospital of Shanghai University of Traditional Chinese Medicine, between March 2015 and October 2016 were recruited and randomly assigned to treatment group and control group, with 30 patients in each group. Patients in treatment group received rubber band ligation combined with hemorrhoidal artery ligation and those in control received sclerotherapy injection. Clinical effectiveness, incidence of complication and recurrence after 6 months of procedures were compared between the two groups. Results Overall effectiveness was significantly better in treatment group than in control group (P < 0.05). There was no serious complications during the operation. There was no significant difference between the two groups in pain at 1^st, 3^rd, 5^th, and 7^th day and defecation at 2^nd and 7^th day (P > 0.05). Bleeding at 7th day was significantly less and incidence of recurrence significantly lower in treatment group than in control group (P < 0.05). Conclusion Compared with sclerotherapy injection, rubber band ligation combined with hemorrhoidal artery ligation had better effectiveness, lower recurrence rate and better safety.