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投稿时间：2023-12-22 网络发布日期：2024-11-20
投稿时间：2023-12-22 网络发布日期：2024-11-20
中文摘要: 目的 探讨内镜下负压套扎术联合硬化剂注射治疗内痔出血的临床疗效，并分析术后并发症危险因素。方法 选取安丘市人民医院肛肠外科2021年3月至2023年3月收治的Ⅱ~Ⅲ度内痔患者210例，按数字表法随机分为对照组（105例）和联合组（105例），对照组采用内镜下负压套扎术治疗，联合组采用内镜下负压套扎术联合硬化剂注射治疗，比较两组患者手术治疗疗效及术后并发症发生情况。根据术后并发症发生情况分为并发症组和无并发症组，采用logistic多因素回归分析患者术后发生并发症的危险因素。结果 联合组总有效率高于对照组，差异有统计学意义（97.14% vs 86.67%，P＜0.05）。联合组手术时间长于对照组，术中出血量低于对照组，内痔脱落时间及住院时间均短于对照组，并发症总发生率低于对照组，差异有统计学意义（P＜0.05）。Logistic多因素回归分析显示，年龄≥50岁、病程≥1年、内痔程度Ⅲ度、辛辣饮食、内痔脱落时间≥7 d、首次排便时间＜24 h均为内痔术后发生并发症的独立危险因素（P＜0.05）。结论 内镜下负压套扎术联合硬化剂注射治疗内痔临床效果较好，并发症发生率较低，高龄、病程长、内痔脱垂程度严重、辛辣饮食、内痔脱落时间长、首次排便时间过早均为内痔术后并发症的危险因素，临床应针对以上危险因素制定有效干预措施，以提升手术治疗效果。
Abstract:Objective To investigate the clinical efficacy of endoscopic negative pressure ligation combined with sclerotherapy in the treatment of internal hemorrhoidal hemorrhage, and to analyze the risk factors of postoperative complications. Methods A total of 210 patients with grade Ⅱ to Ⅲ internal hemorrhoids admitted to the Department of Colorectal Surgery of our hospital from March 2021 to March 2023 were randomly divided into a control group (105 cases) and a combination group (105 cases) using a digital table method. The control group received endoscopic negative pressure ligation treatment, while the combination group received endoscopic negative pressure ligation combined with sclerotherapy injection treatment. The surgical treatment efficacy and postoperative complications of the two groups of patients were compared. According to the incidence of postoperative complications, patients were divided into complication group and non complication group, and logistic multiple regression analysis was used to identify the risk factors for postoperative complications in patients. Results The total effective rate of the combined group was higher than that of the control group, the difference was statistically significant (97.14% vs 86.67%, P＜0.05). The operative time of the combined group was longer than that of the control group, the intraoperative blood loss was lower than that of the control group, the internal hemorrhoidal shedding time and hospital stay were shorter than that of the control group, and the total incidence of complications was lower than that of the control group, the difference was statistically significant (P＜0.05). Multivariate logistic regression analysis showed that age ≥50 years old, duration ≥1 year, degree Ⅲ of internal hemorrhoids, spicy diet, shedding time ≥7 d and first defecation time＜24 h were all independent risk factors for postoperative complications of internal hemorrhoids (P＜0.05). Conclusion Endoscopic negative pressure ligation combined with sclerosing agent injection has good clinical effect and low complication rate. Advanced age, long course of disease, severe prolapse degree of internal hemorrhoids, spicy diet, long time of internal hemorrhoids loss, and premature first defecation are all risk factors for postoperative complications of internal hemorrhoids. Effective intervention measures should be developed by acupuncture above risk factors to improve the therapeutic effect of surgery.
keywords: Negative pressure ligation surgery Hardening agent Internal hemorrhoids Complications Risk factors
文章编号： 中图分类号：R727.4 文献标志码：A
基金项目:
附件
| 作者 | 单位 |
| 沈宝龙 | 1. 山东第二医科大学，山东 潍坊 262100 |
| 栾晓琳 | 2. 安丘市人民医院，山东 潍坊 262100 |
| 李龙彬 | 2. 安丘市人民医院，山东 潍坊 262100 |
| 任斌 | 3. 山东第二医科大学附属医院，山东 潍坊 262100 |
| Author Name | Affiliation |
| SHEN Baolong, LUAN Xiaolin, LI Longbin, REN Bin | *Shandong Second Medical University, Weifang, Shandong 262100, China |
引用文本：
沈宝龙,栾晓琳,李龙彬,等.内镜下负压套扎术联合硬化剂注射治疗内痔出血的疗效及术后并发症危险因素[J].中国临床研究,2024,37(11):1735-1739.
沈宝龙,栾晓琳,李龙彬,等.内镜下负压套扎术联合硬化剂注射治疗内痔出血的疗效及术后并发症危险因素[J].中国临床研究,2024,37(11):1735-1739.