经内镜痔上直肠黏膜套扎治疗内痔并脱出112例临床观察(含视频)
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1.黔东南苗族侗族自治州人民医院消化内科;2.华中科技大学同济医学院附属协和医院消化内科

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Clinical evaluation of endoscopic super-hemorrhoidal banding for 112 cases of internal hemorrhoids with prolapse (with video)
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1.the people&2.#39;3.&4.s hospital of the Qiandongnan Miao and Dong autonomous prefecture

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    摘要:

    目的 评估经内镜痔上直肠黏膜套扎(super-hemorrhoidal banding,SHB)治疗内痔并脱出的安全性和有效性。方法 对2019年6月—2020年6月黔东南苗族侗族自治州人民医院收治的112例Ⅱ~Ⅲ度内痔患者进行SHB治疗。随访时间超过6个月。前瞻性观察SHB治疗内痔并脱出的疗效,术中、术后并发症及满意度。结果 共112例内痔患者接受SHB治疗,其中Ⅱ度74例(66.1%),Ⅲ度38例(33.9%)。患者手术均成功,术中无肛门疼痛、出血等症状。术后出现不同程度肛门坠胀感,持续2~24 h后症状消除。5例Ⅲ度内痔患者术后出现排尿困难,局部热敷刺激膀胱后得到改善;1例Ⅲ度内痔患者术后第14天便血,在出血溃疡处再次套扎治疗出血停止。患者均完成随访,术后1个月随访,均无出血、疼痛、感染、狭窄等并发症。18例Ⅲ度内痔患者术后仍有部分痔脱出,但无出血等其他症状,其中6例患者再次行SHB治疗后无痔脱出。全部患者完成术后6个月随访,无并发症发生,调查患者满意度为100.0%。结论 SHB是一种有效、安全、简便的内镜下治疗内痔合并脱出的方法。

    Abstract:

    Objective To evaluate the safety and efficacy of endoscopic super-hemorrhoidal banding (SHB) in the treatment of internal hemorrhoids with prolapse. Methods From June 2019 to June 2020, a total of 112 patients with grade Ⅱ and Ⅲ internal hemorrhoids underwent endoscopic SHB at People's Hospital of Qiandongnan Miao and Dong Autonomous Prefecture. The efficacy of SHB, intraoperative and postoperative complications associated with the operation and patients' satisfaction were prospectively studied. The follow-up time was over six months. Results A total of 112 patients received SHB for internal hemorrhoids, 74 patients (66.1%) with grade Ⅱ hemorrhoids and 38 patients (33.9%) with grade Ⅲ hemorrhoids. The operations were successfully performed in all patients. No anal pain or bleeding was reported during the operation. All patients experienced various degrees of anal bulge after the operation, which lasted for 2-24 hours before spontaneous disappearance. Five patients with grade Ⅲ internal hemorrhoids showed dysuria, which was relieved with local heat on the bladder. One patient with grade Ⅲ internal hemorrhoid had bloody stool on day 14. The bleeding was stopped with another banding at the site of bleeding ulcer. All patients completed the follow-up. No complications such as bleeding, pain, infection or stenosis occurred in one month after operation. Eighteen patients with grade Ⅲ had partial prolapse after operation without bleeding or other symptoms. Six of them received additional SHB treatment and prolapse disappeared. No postoperative complications occurred in the six months of follow-up in all patients. The satisfaction rate was 100.0% according to the survey. Conclusion Endoscopic SHB is an effective, safe and simple technique for internal hemorrhoids with prolapse.

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黄秀江,林浩,姜平,等.经内镜痔上直肠黏膜套扎治疗内痔并脱出112例临床观察(含视频)[J].中华消化内镜杂志,2021,38(9):707-711.

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  • 收稿日期:2021-05-27
  • 最后修改日期:2021-08-16
  • 录用日期:2021-07-16
  • 在线发布日期: 2021-09-27
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