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内镜下套扎术与硬化剂注射疗法治疗内痔的疗效及对肛门直肠功能影响的比较

The Comparison Between Endoscopic Ligation and Sclerotherapy on the Treatment Effect and Anorectal Function in Patients With Internal Hemorrhoids.

作者信息

Zhang Di, Huang Rui, Ma Tao, Yang Mei, Lei Lei, Li Zhenmao, Zhang Yinghui

机构信息

Department of Gastroenterology and Hepatology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

出版信息

Surg Laparosc Endosc Percutan Tech. 2025 Aug 1;35(4):e1381. doi: 10.1097/SLE.0000000000001381.

Abstract

OBJECTIVE

To evaluate the treatment effect of endoscopic ligation and cap-assisted endoscopic sclerotherapy (CAES) for patients with internal hemorrhoids, symptom relief, complication rate and psychological condition, and the anorectal function were observed.

METHODS

Thirty-two patients who underwent minimally invasive endoscopic treatment for internal hemorrhoids were recruited, with a 3-month follow-up. Patients were divided into 2 groups, with Group A undergoing endoscopic ligation (n=14) and Group B receiving CAES (n=18). The Clinical efficacy and anorectal function between the 2 groups before and after treatment were compared, and the psychological changes in patients before and after treatment were evaluated by various scales.

RESULTS

There was no significant difference in the treatment effect of postoperative bleeding, prolapse, constipation, and complications between the 2 groups. However, Group A has certain advantages in the treatment of prolapse and constipation before and after treatment, and Group B has certain advantages in bleeding. The comprehensive multiscale psychological evaluation showed no significant difference between the 2 groups before and after treatment, but the psychological condition of patients in both groups was significantly improved after treatment. Besides, patients in Group A were better in the improvement of constipation scale, and patients in Group B had a greater improvement in the pain scale. As for anorectal function, there was no significant difference before and after treatment, except for the squeeze duration before treatment. In the comparison pretreatment and post-treatment, patients in Group A had significant differences in resting (average), first defecation and squeeze (average), while patients in Group B had significant differences in resting (average) and first defecation.

CONCLUSIONS

Two endoscopic therapies were effective in treating internal hemorrhoids, with no significant difference in terms of treatment effect, symptom relief, complication rate, psychological condition, and anorectal function when compared between 2 groups. However, when compared within each group, the different methods had their own advantages in the evaluation of treatment effect and anorectal function.

摘要

目的

评估内镜下套扎术和套扎辅助内镜硬化治疗(CAES)对内痔患者的治疗效果、症状缓解情况、并发症发生率及心理状况,并观察其肛门直肠功能。

方法

招募32例行内痔微创内镜治疗的患者,进行3个月的随访。将患者分为2组,A组行内镜下套扎术(n = 14),B组接受CAES(n = 18)。比较两组治疗前后的临床疗效和肛门直肠功能,并通过多种量表评估患者治疗前后的心理变化。

结果

两组术后出血、脱垂、便秘及并发症的治疗效果无显著差异。然而,A组在治疗前后的脱垂和便秘治疗方面有一定优势,B组在出血方面有一定优势。综合多量表心理评估显示,两组治疗前后无显著差异,但两组患者治疗后的心理状况均有显著改善。此外,A组患者在便秘量表改善方面较好,B组患者在疼痛量表改善方面更大。至于肛门直肠功能,除治疗前的挤压持续时间外,治疗前后无显著差异。在治疗前后比较中,A组患者在静息(平均)、首次排便和挤压(平均)方面有显著差异,而B组患者在静息(平均)和首次排便方面有显著差异。

结论

两种内镜治疗方法对内痔均有效,两组在治疗效果、症状缓解、并发症发生率、心理状况和肛门直肠功能方面比较无显著差异。然而,在每组内部比较时,不同方法在治疗效果和肛门直肠功能评估方面各有优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43c7/12303241/2fb082e8300e/sle-35-e1381-g001.jpg

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