Department of Surgery, Deventer Hospital, Deventer, The Netherlands.
Dig Surg. 2010;27(4):279-84. doi: 10.1159/000280020. Epub 2010 Jul 31.
This study was designed to determine the effect of treating hemorrhoids with the Doppler-guided hemorrhoidal artery ligation (DG-HAL) procedure.
From June 2005 to March 2008, 244 consecutive hemorrhoidal patients underwent hemorroidal artery ligation performed with the DG-HAL system from AMI. All patients were evaluated postoperatively with a proctologic examination and interview. Further follow-up was performed by telephone with a standardized questionnaire. When indicated, patients revisited the clinic for further examination and treatment.
244 patients were treated with DG-HAL. The mean follow-up time was 18.4 months (range 1.4-37.2). Sixty-seven percent of the patients had an improvement of symptoms after one treatment. Fifty-three patients (22%) underwent a second procedure because of persisting symptoms. Thirteen patients (25%) underwent a second DG-HAL and 40 (75%) underwent rubber band ligation. In total, 69% of the patients had a good response using the DG-HAL technique. Multivariate logistic regression analysis revealed prolapse to be an independent risk factor for persistent symptoms (OR = 2.38, 95% CI 1.10-5.15). Patients with grades 3 and 4 hemorrhoids had a higher risk of developing recurrent disease (OR = 4.94, 95% CI 0.67-36.42).
DG-HAL seems to be an effective procedure for treating low-grade hemorrhoids. A resection procedure should be the treatment for patients with recurrent disease.
本研究旨在确定多普勒引导痔动脉结扎术（DG-HAL）治疗痔的效果。
2005 年 6 月至 2008 年 3 月，244 例连续痔病患者接受 AMI 的 DG-HAL 系统进行痔动脉结扎术。所有患者术后均行直肠检查和访谈进行评估。进一步通过电话随访，采用标准化问卷。必要时，患者复诊进行进一步检查和治疗。
244 例患者接受了 DG-HAL 治疗。平均随访时间为 18.4 个月（范围 1.4-37.2）。67%的患者单次治疗后症状改善。53 例（22%）因持续症状接受第二次手术。13 例（25%）再次接受 DG-HAL，40 例（75%）接受橡皮圈结扎。总共有 69%的患者对 DG-HAL 技术有良好的反应。多变量逻辑回归分析显示脱垂是持续症状的独立危险因素（OR=2.38，95%CI 1.10-5.15）。3 级和 4 级痔患者复发疾病的风险更高（OR=4.94，95%CI 0.67-36.42）。
DG-HAL 似乎是治疗低级别痔的有效方法。对于复发病例，应采用切除术。
