手法按摩在内镜下泡沫硬化剂注射治疗Ⅰ度出血性内痔中的价值

Clinical value of manual massage in treatment of grade I internal hemorrhoids under endoscopic foam sclerotherapy

目的评价手法按摩对内镜下泡沫硬化剂注射治疗Ⅰ度内痔术后并发症的影响。方法前瞻性纳入连续就诊的Ⅰ度内痔患者133例,完成内镜下泡沫硬化剂注射治疗。术后随机分为按摩组(n=65)和对照组(n=68),按摩组行肛周手法按摩。采用视觉模拟评分法(VAS)评价术后肛周疼痛情况,比较术后出血情况、短期疗效和长期疗效。结果按摩组,术后24 h VAS为1.0(0.0,3.0)分,明显低于对照组的2.0(1.0,4.0)分,差异有统计学意义(P=0.014);按摩组术后1周未出血者占84.6%,明显高于对照组的64.7%,差异有统计学意义(P=0.009)。术后12周、6个月和12个月,两组患者短期治愈率和长期治愈率比较,差异均无统计学意义(P>0.05)。结论内镜下泡沫硬化剂注射后行手法按摩,有利于缓解Ⅰ度内痔术后疼痛,减少出血。

Objective To evaluate the effect of manual massage on complications after endoscopic foam sclerotherapy injection for the treatment of internal hemorrhoids.Methods Consecutive 113 patients with gradeⅠinternal hemorrhoids were prospectively enrolled and completed endoscopic foam sclerotherapy.The patients were randomly divided into a massage group(n=65)and a control group(n=68).Massage group performed manual perianal massage,Visual analogue scale(VAS)was used to evaluate perianal pain.The postoperative bleeding,shortterm and long-term efficacy were also compared.Results The median VAS of 24 h postoperation was 1.0(0.0,3.0)in massage group,which was significantly lower than 2.0(1.0,4.0)in control group,the difference was statistically significant(P=0.014).The no bleeding rate of one week postoperation was 84.6%in massage group,which was significantly higher than 64.7%in control group,the difference was statistically significant(P=0.009).After 12 weeks,6 months and 12 months of follow-up,there were no significant differences in cure rate and remission rate between the two groups(P>0.05).Conclusion Manual massage after endoscopic sclerosing agent injection is beneficial to relieve postoperative pain of grade I internal hemorrhoids and reduce bleeding.