透明帽辅助内镜下应用聚桂醇硬化注射治疗Ⅰ/Ⅱ/Ⅲ度内痔的效果观察

Observation on the effect of polyglycolic acid hardening injection with transparent cap assisted endoscopy for the treatment of gradeⅠ/Ⅱ/Ⅲinternal hemorrhoids

目的观察在透明帽辅助内镜下应用聚桂醇硬化术治疗Ⅰ/Ⅱ/Ⅲ度内痔的效果,及对患者排便功能和血清C反应蛋白(CRP)、皮质醇(COR)水平的影响。方法75例接受透明帽辅助内镜治疗的Ⅰ/Ⅱ/Ⅲ度内痔患者分为观察组38例和对照组37例,内镜下分别用聚桂醇硬化注射、常规硬化注射,比较2组临床疗效、并发症以及患者排便功能和血清CRP、COR的变化情况。结果2组治疗总有效率差异无统计学意义(χ2=1.972,P=0.160),但观察组的疗效等级优于对照组,差异有统计学意义(Z=2.440,P=0.015);观察组肛门疼痛、组织溃疡、再出血的发生率(7.89%、10.53%、0)均低于对照组(27.03%、29.73%、10.81%),差异有统计学意义(均P<0.05)。与术前相比,2组患者术后24、72 h的Heikkinen评分均升高,差异有统计学意义(均P<0.05);术后72 h,观察组的Heikkinen评分高于对照组,差异有统计学意义(t=7.684,P<0.05)。术后12 h、术后24 h,2组的血清CRP、COR水平差异有统计学意义(P<0.05);对照组术后24 h的血清CRP、COR水平均高于术后12 h(t=4.544、2.095),差异有统计学意义(P<0.05)。结论在透明帽辅助内镜下运用聚桂醇局部硬化注射治疗Ⅰ/Ⅱ/Ⅲ度内痔,可改善患者排便功能,减少术后并发症。

Objective To observe the effect of polyglycolic acid hardening injection with transparent cap assisted endoscopy for the treatment of gradeⅠ/Ⅱ/Ⅲinternal hemorrhoids,and its impact on patient’s bowel function and serum levels of C-reactive protein(CRP)and cortisol(COR).Methods A total of 75 patients with gradeⅠ/Ⅱ/Ⅲinternal hemorrhoids who underwent transparent cap assisted endoscopic treatment were divided into an observation group of 38 cases and a control group of 37 cases.Polyglycolic acid hardening injection and conventional hardening injection were used respectively,and the clinical efficacy,complications,and changes in patient’s bowel function and serum CRP and COR levels were compared between the two groups.Results There was no statistically significant difference in the total effective rate of treatment between the two groups(χ^(2)=1.972,P=0.160),but the efficacy level of the observation group was superior to that of the control group,with a statistically significant difference(Z=2.440,P=0.015).The incidence of anal pain,tissue ulceration,and rebleeding in the observation group(7.89%,10.53%,0)was lower than that in the control group(27.03%,29.73%,10.81%),with statistically significant differences(all P<0.05).Compared with before the operation,the Heikkinen score of patients in both groups increased significantly at 24 and 72 hours after the operation(all P<0.05).At 72 hours after the operation,the Heikkinen score of the observation group was higher than that of the control group,with a statistically significant difference(t=7.684,P<0.05).At 12 and 24 hours after the operation,there were statistically significant differences in serum CRP and COR levels between the two groups(P<0.05).The serum CRP and COR levels of the control group at 24 hours after the operation were higher than those at 12 hours after the operation(t=4.544,2.095),with statistically significant differences(P<0.05).Conclusions The use of polyglycolic acid local hardening injection with transparent cap assisted endoscopy for the treatment of grade Ⅰ/Ⅱ/Ⅲ internal hemorrhoids can improve patient’s bowel function and reduce postoperative complications.