内镜下套扎硬化注射术联合中药熏蒸治疗内痔的疗效研究

Clinical Efficacy of Endoscopic Ligation and Sclerotic Injection Combined with Chinese Herbal Fumigation in Treatment of Internal Hemorrhoids

目的:探究内镜下套扎硬化注射术联合中药熏蒸治疗内痔的效果及不良反应。方法:选取2023年1~12月,本院收治的120例内痔患者。根据治疗方法不同,分为套扎组(内镜下套扎治疗)、套扎熏蒸组(内镜下套扎联合中药熏蒸治疗)、硬化组(内镜下硬化剂注射治疗)、硬化熏蒸组(内镜下硬化剂注射联合中药熏蒸治疗)、套扎硬化组(内镜下套扎注射治疗)和套扎硬化熏蒸组(内镜下套扎注射联合中药熏蒸治疗),每组各20例。观察比较各组术后疼痛、便血和尿潴留情况。结果:套扎熏蒸组手术当日,术后3d和7d的疼痛评分均明显低于套扎组(P<0.05);套扎硬化熏蒸组各时点疼痛评分均明显低于套扎硬化组(P<0.05);硬化熏蒸组和硬化组各时点疼痛评分比较差异无统计学意义(P>0.05)。套扎组术后便血6例,尿潴留1例;套扎熏蒸组便血3例,尿潴留1例;硬化组无便血,无尿潴留;硬化熏蒸组便血1例,无尿潴留;套扎硬化组便血1例,尿潴留1例;套扎硬化熏蒸组便血1例,尿潴留1例。硬化组、硬化熏蒸组、套扎硬化组和套扎硬化熏蒸组出血率均显著低于套扎组和套扎熏蒸组(P<0.05),各组术后尿潴留发生率比较差异无统计学意义(P>0.05)。结论:内痔硬化术后疼痛、便血、尿潴留发生率明显低于内痔套扎术及套扎硬化术,联合中药熏蒸治疗可显著减轻内痔套扎术及套扎硬化术后肛门疼痛。内镜下套扎硬化注射术联合中药熏蒸治疗内痔的效果确切,术后疼痛轻,并发症少,值得临床推广应用。

Objective To explore the efficacy and side effects of endoscopic ligation and sclerotic injection combined with Chinese herbal fumigation in the treatment of internal hemorrhoids.Methods Total 120 patients with internal hemorrhoids treated in our hospital from January to December 2023 were selected.According to the different treatment methods,the patients were divided into ligation group(endoscopic ligation treatment),ligation and fumigation group(endoscopic ligation combined with Chinese herbal fumigation treatment),sclerosing group(endoscopic sclerotic injection treatment),sclerosing and fumigation group(endoscopic sclerotic injection combined with Chinese herbal fumigation treatment),ligation and sclerosing group(endoscopic ligation combined with sclerotic injection treatment),and ligation,sclerosing and fumigation group(endoscopic ligation and sclerotic injection combined with Chinese herbal fumigation).There were 20 cases in each group.The postoperative pain,hematochezia and urinary retention were observed and compared.Results The pain scores on the day of operation,3 and 7 days after operation in the ligation and fumigation group were significantly lower than those in the ligation group(P<0.05).The pain scores at each time-point of the ligation,sclerosing and fumigation group were significantly lower than those of the ligation and sclerosing group(P<0.05).There was no significant difference in the pain scores between the sclerosing and fumigation group and the sclerosing group(P>0.05).There were six cases of hematochezia and one case of urine retention in the ligation group.In the ligation and fumigation group,there were three cases of hematochezia and one case of urine retention.There was no hematochezia or urine retention in the sclerosing group.In the sclerosing and fumigation group,there was one case of hematochezia and no urinary retention.In the ligation and sclerosing group,one case had hematochezia and one case had urinary retention.There was one case of hematochezia and one case of urinary retention in the ligation,sclerosing and fumigation group.The bleeding rate of the sclerosing group,sclerosing and fumigation group,ligation and sclerosing group and ligation,sclerosing and fumigation group was significantly lower than that of the ligation group and ligation and fumigation group(P<0.05),and there was no statistically significant difference in the incidence of postoperative urinary retention between all groups(P>0.05).Conclusion The incidence of postoperative pain,hematochezia and urinary retention of internal hemorrhoidal sclerotic injection is significantly lower than that of internal hemorrhoidal ligation and ligation combined with sclerotic injection.Combined with Chinese herbal fumigation,it can significantly reduce anal pain after internal hemorrhoidal ligation and ligation combined with sclerotic injection.Endoscopic ligation and sclerotic injection combined with Chinese herbal fumigation in the treatment of internal hemorrhoids is effective,with mild postoperative pain and few complications,which is worthy of clinical application.