弹力线套扎治疗Ⅲ°~Ⅳ°非环状混合痔的临床疗效

Clinical effect of elastic thread ligation in the treatment ofⅢ°-Ⅳ°non-annular mixed hemorrhoids

目的探讨弹力线套扎(elastic thread ligation,ETL)治疗Ⅲ°~Ⅳ°非环状混合痔的临床疗效。方法选取2020年7月至2022年1月遵义医科大学第三附属医院肛肠科收治的100例Ⅲ°~Ⅳ°非环状混合痔患者作为研究对象,随机分为ETL组与橡皮筋结扎(rubber band ligation,RBL)组,每组50例。ETL组行ETL治疗,RBL组行RBL治疗。比较两组手术时间、住院时间、恢复工作时间、套扎创面愈合时间、术后第1天视觉模拟评分法(visual analogue scale,VAS)评分、临床疗效及术后肛门坠胀、术后出血、复发情况。结果ETL组住院时间、恢复工作时间、套扎创面愈合时间均短于RBL组,差异有统计学意义(P<0.05)。ETL组术后无出血发生率为94.00%,高于RBL组的78.00%,差异有统计学意义(P<0.05)。两组手术时间、术后肛门坠胀发生率、术后第1天VAS评分、术后6个月复发率比较差异均无统计学意义。两组治疗总有效率均为100.00%,两组比较差异无统计学意义。结论ETL治疗Ⅲ°~Ⅳ°非环状混合痔疗效显著,可降低患者术后出血发生率,缩短套扎基底部创面愈合时间、住院时间及恢复工作时间,值得临床推广应用。

Objective To investigate the clinical effect of elastic thread ligation(ETL)in the treatment ofⅢ°-Ⅳ°non-annular mixed hemorrhoids.Methods A total of 100 patients withⅢ°-Ⅳ°non-annular mixed hemorrhoids admitted to the Anorectal Department of the Third Affiliated Hospital of Zunyi Medical University from July 2020 to January 2022 were selected as the study subjects,and they were randomly divided into the ETL group and the rubber band ligation(RBL)group,with 50 cases in each group.The ETL group received ETL treatment,the RBL group received RBL treatment.The operation time,hospitalization time,return to work time,healing time of ligature wound,visual analogue score(VAS)on the first day after surgery,clinical efficacy,postoperative anal distention,postoperative bleeding and recurrence were compared between the two groups.Results The hospitalization time,return to work time,and healing time of the ligature wound in the ETL group were shorter than those in the RBL group,and the differences were statistically significant(P<0.05).The incidence of postoperative bleeding-free in the ETL group was 94.00%,which was higher than 78.00%in the RBL group,and the difference was statistically significant(P<0.05).There were no significant differences in operation time,incidence of anal distention,VAS score on the first day after surgery and recurrence rate at 6 months after surgery between the two groups.The total effective rate of the two groups was 100.00%,the difference was not statistically significant between the two groups.Conclusion ETL is effective in the treatment ofⅢ°-Ⅳ°non-annular mixed hemorrhoids,which can reduce the incidence of postoperative bleeding,shorten the healing time of basal ligation wound,hospitalization time and return to work time,and is worthy of clinical promotion and application.