Zhou H, Li L, Wang W J, Li Y L
Department of Interventional and Minimally Invasive Tumor Therapy, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, China.
Department of Anesthesia and Surgery,Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China.
Zhonghua Nei Ke Za Zhi. 2024 Sep 1;63(9):861-865. doi: 10.3760/cma.j.cn112138-20231123-00337.
To investigate the safety and efficacy of percutaneous superselective superior rectal artery embolization in the treatment of grades Ⅱ-Ⅲ internal hemorrhoids. The clinical data of 22 patients with grades Ⅱ-Ⅲ internal hemorrhoids who underwent superselective superior rectal artery embolization in the Department of Interventional and Minimally Invasive Tumor Therapy of the Second Hospital of Shandong University from September 2019 to February 2022 were retrospectively analyzed. According to the blood supply artery of hemorrhoids, superselective embolization was performed with embolization materials. The surgical efficacy,postoperative complications,and 12-month follow-up results were analyzed. The clinical score data (French bleeding score,quality of life score,prolapse score) were expressed using the median (, ). The clinical scores before and after treatment were compared by the nonparametric rank sum test (Wilcoxon test),and the -value was calculated. -values <0.05 indicate statistically significant differences. The operation was successful in all 22 patients (technical success rate: 100%). The main postoperative side effects and complications included tenesmus (81.8%,18/22),anal bulge (68.2%,15/22),and mild pain in the anus (22.7%,5/22). The above reactions were improved 3-5 days after operation; three patients had congestion and dull pain at the puncture site,which improved spontaneously without treatment. The patients were followed up for 12 months. Compared with those prior to operation, the French bleeding score,quality of life score,and prolapse score were significantly improved (all <0.05). Superselective superior rectal artery embolization is a relatively safe and low-risk treatment for grades Ⅱ-Ⅲ internal hemorrhoids. It is an option for the treatment of internal hemorrhoids,particularly hemorrhagic internal hemorrhoids.
探讨经皮超选择性直肠上动脉栓塞术治疗Ⅱ-Ⅲ度内痔的安全性及有效性。回顾性分析2019年9月至2022年2月在山东大学第二医院介入与微创肿瘤治疗科接受超选择性直肠上动脉栓塞术的22例Ⅱ-Ⅲ度内痔患者的临床资料。根据痔的供血动脉,采用栓塞材料进行超选择性栓塞。分析手术疗效、术后并发症及12个月随访结果。临床评分数据(法国出血评分、生活质量评分、脱垂评分)用中位数(,)表示。采用非参数秩和检验(Wilcoxon检验)比较治疗前后的临床评分,并计算P值。P值<0.05表示差异有统计学意义。22例患者手术均成功(技术成功率:100%)。术后主要副作用及并发症包括里急后重(81.8%,18/22)、肛门坠胀(68.2%,15/22)及肛门轻度疼痛(22.7%,5/22)。上述反应术后3-5天改善;3例穿刺部位出现淤血、隐痛,未经治疗自行好转。对患者进行12个月随访。与术前比较,法国出血评分、生活质量评分及脱垂评分均显著改善(均P<0.05)。超选择性直肠上动脉栓塞术治疗Ⅱ-Ⅲ度内痔相对安全、风险低。是治疗内痔尤其是出血性内痔的一种选择。