内镜下套扎术、内镜下硬化剂注射疗法及吻合器痔上黏膜环切术对老年Ⅱ~Ⅲ度内痔患者围术期指标、疼痛及并发症的影响

The Effects of Endoscopic Ligation,Endoscopic Sclerotherapy Injection,and Stapler Hemorrhoidectomy on Perioperative Indicators,Pain,and Complications in Elderly Patients with Grade Ⅱ to Ⅲ Internal Hemorrhoids

目的:比较内镜下套扎术、内镜下硬化剂注射疗法和吻合器痔上黏膜环切术对老年Ⅱ~Ⅲ度内痔患者围术期指标、疼痛及并发症的影响。方法:选取2022年1月~2023年4月本院收治的93例老年Ⅱ~Ⅲ度内痔患者,按照随机分组原则分为内镜下套扎术组、内镜下硬化剂注射疗法组和吻合器痔上黏膜环切术组。比较三组患者的手术时间、住院时间、疼痛程度、并发症发生率以及治疗总有效率。结果:内镜下套扎术组的平均手术时间显著低于内镜下硬化剂注射疗法组和吻合器痔上黏膜环切术组(P<0.05);内镜下套扎术组的平均住院时间显著短于内镜下硬化剂注射疗法组和吻合器痔上黏膜环切术组(P<0.05);内镜下套扎术组的疼痛程度显著低于内镜下硬化剂注射疗法组和吻合器痔上黏膜环切术组(P<0.05);并发症发生率方面,内镜下套扎术组的尿潴留、术后出血及吻合口创面感染发生率均低于其他两组(P<0.05);治疗总有效率方面,内镜下套扎术组高于内镜下硬化剂注射疗法组和吻合器痔上黏膜环切术组(P<0.05)。结论:内镜下套扎术在老年Ⅱ~Ⅲ度内痔患者中具有手术时间短、住院时间短、疼痛程度轻、并发症发生率低以及治疗总有效率高的优势。

Objective:To compare the effects of endoscopic ligation,endoscopic sclerotherapy injection,and stapler hemorrhoidectomy on perioperative indicators,pain,and complications in elderly patients with grade Ⅱ to Ⅲ internal hemorrhoids.Methods:93 elderly patients with grade Ⅱ to Ⅲ internal hemorrhoids admitted to our hospital from January 2022 to April 2023 were randomly divided into three groups:endoscopic ligation group,endoscopic sclerotherapy injection group,and stapler hemorrhoid mucosal circumcision group.Compare the surgical time,hospital stay,degree of pain,incidence of complications,and overall treatment efficiency of the three groups of patients.Results:The average operating time of the endoscopic ligation group was significantly lower than that of the endoscopic sclerotherapy group and the stapler hemorrhoid mucosal circumcision group(P<0.05);The average hospitalization time of the endoscopic ligation group was significantly shorter than that of the endoscopic sclerotherapy group and the stapler hemorrhoid supramucosal circumcision group(P<0.05);The pain level in the endoscopic ligation group was significantly lower than that in the endoscopic sclerotherapy group and the stapler hemorrhoid supramucosal circumcision group(P<0.05);In terms of the incidence of complications,the incidence of urinary retention,postoperative bleeding and anastomotic wound infection in the endoscopic ligation group were lower than those in the other two groups(P<0.05);In terms of total effective rate of treatment,the endoscopic ligation group was higher than the endoscopic sclerotherapy injection group and the stapler hemorrhoidectomy group(P<0.05).Conclusion:Endoscopic ligation has significant advantages in short surgical time,short hospital stay,mild pain,low incidence of complications,and high overall treatment effectiveness in elderly patients with grade Ⅱ to Ⅲ internal hemorrhoids.