透明帽辅助内镜下套扎术治疗出血性内痔的临床疗效及对患者术后疼痛程度、并发症、复发率的影响

Clinical effect of transparent cap-assisted endoscopic ligation on hemorrhagic internal hemorrhoids and its influence on postoperative pain degree,complications and recurrence rate

目的研究透明帽辅助内镜下套扎术治疗出血性内痔的疗效。方法收集2020年3月至2021年3月在河南大学第一附属医院收治的60例Ⅰ~Ⅲ度出血性内痔患者作为研究对象。根据手术方案不同,将其分为传统套扎术组和内镜下套扎术组,每组30例。传统套扎术组应用传统痔疮套扎术治疗,内镜下套扎术组应用内镜下套扎术治疗。比较两组围手术期指标(手术时间、术中总出血量)、康复情况(总住院时间、术后首次排便时间、伤口愈合时间),术后4 h、8 h、24 h时疼痛程度视觉模拟评分(VAS),术后1周内并发症发生率(肛门坠胀、出血、排便困难),临床效果以及术后6个月复发率。结果内镜下套扎术组患者手术时间、术中总出血量、总住院时间、术后首次排便时间、伤口愈合时间均明显小于传统套扎术组(P<0.05)。术后4 h、8 h、24 h时内镜下套扎术组患者VAS评分均明显小于传统套扎术组(P<0.05)。内镜下套扎术组治愈率和总有效率均显著高于传统套扎术组(P<0.05)。术后1周内内镜下套扎术组患者肛门坠胀、出血、排便困难不良反应发生率明显低于传统套扎术组(P<0.05)。术后6个月,内镜下套扎术组复发率明显低于传统套扎术组(P<0.05)。结论内镜下痔疮套扎术较传统痔疮套扎术治疗Ⅰ~Ⅲ度内痔,治疗时间短、术中总出血量少,且患者术后并发症发生率和复发率低,有利于患者预后。

【Objective】To investigate the clinical effect of transparent cap-assisted endoscopic ligation in the treatment of hemorrhagic internal hemorrhoids.【Methods】A total of 60 patients with hemorrhagic hemorrhoids of grade I-Ⅲadmitted to our hospital from March 2020 to March 2021 were collected.They were divided into traditional ligation group and endoscopic ligation group by random number table method,with 30 cases in each group.Patients in the traditional ligation group were given traditional hemorrhoid ligation,and patients in the endoscopic ligation group were given endoscopic ligation.The related operative indicators(operation time,total intraoperative blood loss)and rehabilitation situation(total hospitalization time,postoperative first defecation time,wound healing time),the pain degree[Visual Analogue Scale(VAS)]4 hours,8 hours and 24 hours after operation,the total clinical effects,incidence of complications(anal distension,bleeding,difficulty in defecation)within 1 week after operation,the recurrence rate 6 months after operation were compared between the traditional ligation group and the endoscopic ligation group.【Results】The operation time,total intraoperative blood loss,total hospitalization time,postoperative first defecation time,wound healing time in the endoscopic ligation group were shorter than those in the traditional ligation group(P<0.05).VAS score of the endoscopic ligation group was lower than that of the traditional ligation group 4 hours,8 hours and 24 hours after operation(P<0.05).The cure rate and total effective rate in the endoscopic ligation group were significantly higher than those in the traditional ligation group(P<0.05).Within 1 week after operation,the incidence of adverse reactions such as anal distension,bleeding and difficult defecation in endoscopic ligation group was significantly lower than that in traditional ligation group(P<0.05).Six months after operation,the recurrence rate of the endoscopic ligation group was significantly lower than that of the traditional ligation group(P<0.05).【Conclusion】Compared with traditional hemorrhoid ligation,endoscopic hemorrhoid ligation in the treatment of stage I-Ⅲinternal hemorrhoids has shorter treatment time,less intraoperative blood loss,and lower postoperative complication rate and recurrence rate,which is beneficial to the prognosis of hemorrhagic internal hemorrhoids patients.