比较 Ligasure 痔切除术与保守治疗妊娠血栓性外痔(TEH)。
Comparision of Ligasure hemorrhoidectomy and conservative treatment for thrombosed external hemorrhoids (TEH) in pregnancy.
机构信息
Department of Colorectal Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
Department of General Surgery, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
出版信息
BMC Surg. 2023 Jan 19;23(1):15. doi: 10.1186/s12893-023-01910-1.
BACKGROUND
Ligasure hemorrhoidectomy for thrombosed external hemorrhoids in pregnancy has been rarely studied.
OBJECTIVE
The purpose of this article is to study the efficacy and safety of Ligasure hemorrhoidectomy comparing with conservative treatment for thrombosed external hemorrhoids in pregnancy.
DESIGN
This was a retrospective cohort study.
SETTING
The patients were treated at a tertiary referral center in China.
PATIENTS
94 pregnant patients hospitalized for thrombosed external hemorrhoids from September 2020 to December 2021.
INTERVENTIONS
Ligasure hemorrhoidectomy treatment or conservative treatment according to the patient's wishes.
MAIN OUTCOME MEASURES
Symptom relief, recurrence and satisfaction of thrombosed external hemorrhoids in pregnancy with different interventions.
RESULTS
There were no differences between groups in maternal age, gestational age, body mass index, parity, constipation and a prior history of thrombosed external hemorrhoids. The pain scores were less in surgical group than in conservative group in post-treatment days 1 and 7. Time to return to normal activities was shorter in surgical group than in conservative group (6.51 vs. 13.52 days, P < 0.001). Post-treatment complications were mild in surgical group and there were no significant differences concerning the rate of abortion, preterm birth, cesarean delivery and weight of fetus. Recurrence rate was significantly lower in surgical group (8.57% vs. 30.43%, P = 0.017). The patient satisfaction scores were significantly higher in surgical group than in conservative group (Z = - 2.979, P = 0.003).
LIMITATIONS
This was a retrospective study with a limited number of patients, the data was obtained from only one center.
CONCLUSIONS
Comparing with conservative treatment, Ligasure hemorrhoidectomy for TEH in pregnancy results in more rapid pain relief, shorter time to return to normal activities, lower incidence of recurrence, and better patient satisfaction. This type of surgery has low and mild postoperative complications, is not attended by any risk to the mother or her fetus.
背景
痔上动脉结扎术治疗妊娠合并血栓性外痔鲜有研究。
目的
本文旨在研究痔上动脉结扎术治疗妊娠合并血栓性外痔的疗效和安全性。
设计
这是一项回顾性队列研究。
地点
患者在一家中国的三级转诊中心接受治疗。
患者
2020 年 9 月至 2021 年 12 月因血栓性外痔住院的 94 例孕妇。
干预措施
根据患者意愿进行痔上动脉结扎术治疗或保守治疗。
主要观察指标
不同干预措施对妊娠合并血栓性外痔的症状缓解、复发和患者满意度。
结果
两组患者的年龄、孕龄、体重指数、产次、便秘和既往血栓性外痔史无差异。治疗后第 1 天和第 7 天,手术组的疼痛评分低于保守组。手术组恢复正常活动的时间短于保守组(6.51 天比 13.52 天,P<0.001)。手术组的术后并发症较轻,流产、早产、剖宫产和胎儿体重的发生率无显著差异。手术组的复发率明显低于保守组(8.57%比 30.43%,P=0.017)。手术组的患者满意度评分明显高于保守组(Z=-2.979,P=0.003)。
局限性
这是一项回顾性研究,病例数有限,数据仅来自一个中心。
结论
与保守治疗相比,痔上动脉结扎术治疗妊娠合并血栓性外痔可更快缓解疼痛,更快恢复正常活动,降低复发率,提高患者满意度。这种手术的术后并发症发生率低且轻微,不会给母婴带来任何风险。
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