自动定量弹力线痔套扎术治疗Ⅲ、Ⅳ期环状混合痔的临床观察

Clinical effects of automatic quantitative tightening elastic thread ligator in treatment of stage Ⅲ or Ⅳ circular mixed hemorrhoids

目的 探讨使用自动定量收紧弹力线肛肠套扎器(ATH)治疗Ⅲ、Ⅳ期环状混合痔的临床价值.方法 选取2018年1月至2019年7月在本院住院治疗的108例Ⅲ、Ⅳ期环状混合痔患者,分为2组,ATH组58例,采用ATH痔套扎术;选择性痔上黏膜切除吻合术(TST)组50例,采用选择性痔上黏膜切除吻合术;比较2组患者的手术时间、术中出血、术后出血、疗效等指标.结果 2组患者的一般资料相似,具有可比性.2组治疗总有效率均为100%.ATH组在手术时间、术中出血方面优于TST组[手术时间:(18.2±3.4)min vs(31.4±5.4)min,t=-14.93,P<0.0001;术中出血例数:0 vs 31,χ2=28.569,P<0.05].结论 2种手术方式均能有效治疗Ⅲ、Ⅳ期环状混合痔,ATH痔套扎术具有治疗时间短、操作简便、并发症少等优点,值得临床推广.

Objective To evaluate the clinical value of automatic quantitative tightening elastic thread ligator for hemorrhoids(ATH)in the treatment of stageⅢorⅣcircular mixed hemorrhoids.Methods One hundred and eight patients diagnosed with stageⅢandⅣcircular mixed hemorrhoids were enrolled at our hospital from January 2018 to July 2019.They were divided into two groups based on the treatment:58 cases treated with ATH and 50 cases treated with tissue-selecting therapy stapler(TST).Operative time,intraoperative hemorrhage,postoperative hemorrhage,and therapeutic effects of the two groups were compared.Results There were no significant differences in the demographics of patients between the two groups.The effective rates of both groups were 100%(P>0.05).The ATH group was significantly superior to the TST group in operative time[(18.2±3.4)min vs(31.4±5.4)min,t=-14.93,P<0.0001]and intraoperative bleeding(0 vs 31,χ2=28.569,P<0.05).Conclusion ATH and TST can effectively treat stageⅢorⅣcircular mixed hemorrhoids,and ATH has the advantages of shorter treatment time,simpler operation,and less complications.