Ambrose N S, Hares M M, Alexander-Williams J, Keighley M R
Br Med J (Clin Res Ed). 1983 Apr 30;286(6375):1389-91. doi: 10.1136/bmj.286.6375.1389.
Two hundred and sixty eight patients with haemorrhoids were allocated at random to treatment by either photocoagulation (group 1, n=141) or rubber band ligation (group 2, n=127) and followed up for one year. There was no significant difference in the symptomatic outcome of treatment between the two groups at one, four, or 12 months, irrespective of whether first or second degree haemorrhoids were treated. Side effects of treatment (bleeding or severe pain) were significantly more common after rubber band ligation (n=11) than after photocoagulation (n=2; p less than 0.01). Further outpatient treatment, however, was required significantly more often after photocoagulation (n=23) than rubber band ligation (n=6) (p greater than 0.02), and 19 patients (14 in group 1 and five in group 2; NS) subsequently had a haemorrhoidectomy. At one year 26 of 103 patients were dissatisfied after photocoagulation compared with 20 of 88 after rubber band ligation. Photocoagulation is a safe and comfortable treatment which gives long term results that are as good as those of rubber band ligation. Complications are more common after rubber band ligation, but further treatment is required more commonly after photocoagulation.
268例痔疮患者被随机分为两组，分别接受光凝治疗（第1组，n = 141）或橡皮圈套扎治疗（第2组，n = 127），并随访一年。无论治疗的是一度还是二度痔疮，两组在1个月、4个月或12个月时治疗的症状性结果均无显著差异。治疗的副作用（出血或剧痛）在橡皮圈套扎后（n = 11）比光凝后（n = 2；p<0.01）明显更常见。然而，光凝后需要进一步门诊治疗的情况（n = 23）比橡皮圈套扎后（n = 6）明显更频繁（p>0.02），并且19例患者（第1组14例，第2组5例；无显著性差异）随后接受了痔切除术。一年后，光凝治疗的103例患者中有26例不满意，而橡皮圈套扎治疗的88例患者中有20例不满意。光凝是一种安全舒适的治疗方法，其长期效果与橡皮圈套扎一样好。橡皮圈套扎后并发症更常见，但光凝后更常需要进一步治疗。
