内镜痔结扎术治疗症状性内痔的长期疗效和效果。
Long-term outcome and efficacy of endoscopic hemorrhoid ligation for symptomatic internal hemorrhoids.
机构信息
Department of Gastroenterology and Hepatology, Lin-Kou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 333, Taiwan, China.
出版信息
World J Gastroenterol. 2011 May 21;17(19):2431-6. doi: 10.3748/wjg.v17.i19.2431.
AIM
To assess the long-term outcome of endoscopic hemorrhoid ligation (EHL) for the treatment of symptomatic internal hemorrhoids.
METHODS
A total of 759 consecutive patients (415 males and 344 females) were enrolled. Clinical presentations were rectal bleeding (593 patients) and mucosal prolapse (166 patients). All patients received EHL at outpatient clinics. Hemorrhoid severity was classified by Goligher's grading. The mean follow-up period was 55.4 mo (range, 45-92 mo).
RESULTS
The number of band ligations averaged 2.35 in the first session for bleeding and 2.69 for prolapsed patients. Bleeding was controlled in 587 (98.0%) patients, while prolapse was reduced in 137 (82.5%) patients. After treatment, 93 patients experienced anal pain and 48 patients had mild bleeding. Patient subjective satisfaction was 93.6%. Repeat treatment or surgery was performed if symptoms were not relieved in the first session. In the bleeding group, the recurrence rate was 3.7% (22 patients) at 1 year, and 6.6% and 13.0% at 2 and 5 years. In the prolapsed group, the recurrence rate was 3.0%, 9.6% and 16.9% at 1, 2 and 5 years, respectively.
CONCLUSION
EHL is an easy and well-tolerated procedure for the treatment of symptomatic internal hemorrhoids, with good long-term results.
目的
评估内镜痔结扎术（EHL）治疗症状性内痔的长期疗效。
方法
共纳入 759 例连续患者（男 415 例，女 344 例）。临床表现为直肠出血（593 例）和黏膜脱垂（166 例）。所有患者均在门诊接受 EHL 治疗。痔严重程度采用 Goligher 分级。平均随访时间为 55.4 个月（45-92 个月）。
结果
出血患者第一次治疗平均结扎 2.35 个痔，脱垂患者平均结扎 2.69 个痔。587 例（98.0%）出血患者出血得到控制，137 例（82.5%）脱垂患者脱垂得到缓解。治疗后，93 例患者出现肛门疼痛，48 例患者出现轻度出血。患者主观满意度为 93.6%。若首次治疗后症状未缓解，则进行重复治疗或手术。在出血组中，1 年时复发率为 3.7%（22 例），2 年和 5 年时复发率分别为 6.6%和 13.0%。在脱垂组中，1 年、2 年和 5 年时的复发率分别为 3.0%、9.6%和 16.9%。
结论
EHL 是一种治疗症状性内痔的简单且耐受良好的方法，具有良好的长期疗效。
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