用超声刀联合套扎器与传统外剥内扎术治疗重度混合痔的临床疗效比较

Comparison of the Clinical Efficacy of Ultrasonic Scalpel Combined with Ligation Device and Traditional External Stripping and Internal Ligation in the Treatment of Severe Mixed Hemorrhoids

目的 比较超声刀联合套扎器与传统外剥内扎术治疗重度混合痔的临床疗效。方法 选取2018年9月—2019年9月于北京市健宫医院住院的80例重度混合痔患者,依照随机法分为对比组、观察组,每组40例。对比组接受传统外剥内扎术治疗,观察组接受超声刀联合套扎器手术治疗,对比两组临床疗效、术后恢复指标、VAS评分、创缘水肿评分、并发症总发生率。结果 观察组临床总有效率(95.00%)与对比组(92.50%)比较,差异无统计学意义(χ^(2)=0.000,P=1.000)。观察组疼痛持续时间、创面愈合时间、住院时间均短于对比组,使用止痛药物次数低于对比组,治疗费用高于对比组,差异有统计学意义(t=14.831、9.081、7.599、16.017、27.393,P<0.001)。观察组术后1周VAS评分、创缘水肿评分均低于对比组,差异有统计学意义(t=27.652、3.319,P<0.001),观察组并发症总发生率(2.50%)低于对比组(20.00%),差异有统计学意义(χ^(2)=4.507,P=0.034)。结论 超声刀联合套扎器与传统外剥内扎术均可有效改善轻度混合痔患者病情,但超声刀联合套扎器术后患者疼痛、创面水肿等症状更轻,并发症更少,住院时间更短,但治疗费用较高。

Objective To compare the clinical efficacy of ultrasonic scalpel combined with ligation device and traditional external dissection and internal ligation in the treatment of severe mixed hemorrhoids.Methods 80 patients with severe mixed hemorrhoids hospitalized in Beijing Jiangong Hospital from September 2018 to September 2019 were randomly divided into control group and observation group,with 40 cases in each group.The control group received traditional external stripping and internal ligation,and the observation group received ultrasonic knife combined with ligation.The clinical efficacy,postoperative recovery indicators,VAS score,wound margin edema score,and the total incidence of complications were compared between the two groups.Results The total clinical effective rate of the observation group(95.00%) was compared with that of the control group(92.50%),the difference was not statistically significant(χ^(2)=0.000,P=1.000).The duration of pain,wound healing time and hospital stay in the observation group were shorter than those in the control group,the frequency of using analgesics was lower than that in the control group,and the treatment cost was higher than that in the control group,the difference was statistically significant(t=14.831,9.081,7.599,16.017,27.393,P<0.001).The VAS score and wound edge edema score of the observation group at 1 week after operation were lower than those of the control group,the difference was statistically significant(t=27.652,3.319,P<0.001).The total incidence of complications in the observation group(2.50%) was lower than that in the control group(20.00%),the difference was statistically significant(χ^(2)=4.507,P=0.034).Conclusion Ultrasound knife combined with ligation device and traditional external stripping and internal ligation can effectively improve the condition of patients with mild mixed hemorrhoids,but the patients after ultrasonic knife combined with ligation device have less symptoms such as pain and wound edema,and have fewer complications.The hospital stay is shorter,but the cost of treatment is higher.