内镜下橡皮圈套扎治疗Ⅲ度混合痔的效果及对肛门功能的影响

The Effect of Endoscopic Rubber Band Ligation in the Treatment of Third-Degree Mixed Hemorrhoids and Its Effect on Anal Function

目的 探讨内镜下橡皮圈套扎(RBL)治疗Ⅲ度混合痔的效果及对肛门功能的影响。方法 选取2020年6月—2021年5月该院收治的82例Ⅲ度混合痔患者为研究对象,以奇偶数法分为观察组及对照组,各组41例,对照组行传统外剥内扎术,观察组行内镜下RBL治疗,对两组治疗结果进行比较。结果 观察组总有效率为97.56%,较对照组80.49%高,差异有统计学意义(χ^(2)=4.493,P<0.05)。观察组术后VAS评分、出血评分、肛周水肿评分均较对照组低,创面愈合时间较对照组短,差异有统计学意义(P<0.05)。术前,两组肛管舒张压、肛管静息压、最长收缩时间差异无统计学意义(P>0.05);术后,观察组肛管舒张压、肛管静息压、最长收缩时间优于对照组,差异有统计学意义(P<0.05)。结论 橡皮圈套扎治疗Ⅲ度混合痔疗效确切,可减轻术后疼痛、肛门水肿,减少术后出血,还可改善患者肛门功能。

Objective To investigate the effect of endoscopic rubber band ligation(RBL) in the treatment of third-degree mixed hemorrhoids and its effect on anal function. Methods 82 patients with third-degree mixed hemorrhoids who were admitted to the hospital from June 2020 to May 2021 were selected as the research objects, and divided into an observation group and a control group by the odd-even method, with 41 cases in each group, and the control group underwent traditional external stripping and internal ligation, the observation group was treated under endoscopic(RBL) and the treatment results of the two groups were compared. Results The total effective rate of the observation group was 97.56%, which was 80.49% higher than that of the control group, and the difference was statistically significant(χ2=4.493, P <0.05);the postoperative VAS score,bleeding score and perianal edema score of the observation group were lower than those of the control group, the wound healing time was shorter than that of the control group, the difference was statistically significant(P<0.05). Before operation, there was no statistically significant difference in anal diastolic pressure, anal canal resting pressure, and longest contraction time be-tween the two groups(P>0.05);the anal canal diastolic pressure, anal canal resting pressure and the longest systolic time in the observation group postoperative were better than those in the control group, and the differences were statistically significant( P<0.05). Conclusion Rubber band ligation is effective in the treatment of third-degree mixed hemorrhoids, which can reduce postoperative pain, anal edema, reduce postoperative bleeding, and improve the anal function of patients.