关键词: 自动痔套扎, 内痔, 硬化剂, 愈后

Abstract: Objective   To study the clinical effects of automatic hemorrhoidal banding (RPH) combined with sclerosing agent injection in the treatment of second- and third-degree internal hemorrhoids.  Methods   A total of 156 cases of second-degree and third-degree internal hemorrhoids were randomly divided into three groups,namely hemorrhoidal ligation group,RPH group,and (RPH + sclerotherapy injection) group,with 52 cases in each group,and the three groups underwent hemorrhoidal ligation,RPH surgery,and (RPH + sclerotherapy injection) respectively.The surgical effect was evaluated by the three groups such as operation time,hospital stay,hemorrhoidal lump shedding time,postoperative bleeding,postoperative swelling,postoperative margin edema,and postoperative stenosis.  Results   After treatment,the effective rate of all three groups reached 100%.In terms of operation time,hospital stay and hemorrhoidal lump shedding time,the hemorrhoidal ligation group was (34.13±5.80)min,(8.65±0.96)d,(5.94±0.46)d,the RPH group was (22.81±1.95)min,(6.58±0.75)d,(8.02±0.43)d,the (RPH + sclerotherapy injection) group was (23.73±2.02)min,(6.46±0.75)d,(8.00±0.56)d,RPH and (RPH + sclerotherapy injection) group compared with hemorrhoidal ligation group,hemorrhoidal mass shedding time,surgery time and hospital stay shortened,and all were statistically significant (P＜0.05),and the (RPH + sclerotherapy injection) group had less hospital stay than RPH group (P<0.05）. In terms of postoperative bleeding,the hemorrhoidal ligation group was (177.40±30.45)ml,the RPH group was (105.44±15.92)ml,the (RPH + sclerotherapy injection) group was (59.46±14.99)ml,the amount of blood loss in the RPH group and the (RPH + sclerotherapy injection) group was less than that in the hemorrhoidal ligation group (P<0.05),and the blood loss in the (RPH + sclerotherapy injection) group was significantly less than that in the RPH group (P<0.05）. In terms of postoperative swelling,the hemorrhoidal ligation group was 15 cases,the RPH group was 10 cases,the (RPH + sclerotherapy injection) group was 7 cases,the swelling in the RPH group and the (RPH + sclerotherapy injection) group was significantly less than that in the hemorrhoidal ligation group (P<0.05)。 In terms of postoperative edema and stenosis,the hemorrhoidal ligation group was 3 cases and 0 case,RPH group was 2 cases and 0 case,and (RPH + sclerotherapy injection) group was 3 cases and 0 case,and there was no significant difference between the three surgical methods (P>0.05).  Conclusion   RPH combined with sclerosing injection can significantly reduce the postoperative bleeding,hospital stay,and postoperative swelling,and the postoperative effect is satisfactory,which provides a reliable basis for the clinical treatment of Ⅱ and Ⅲ.degree internal hemorrhoids.

Key words: automatic hemorrhoidal ligation, internal hemorrhoids, hardeners, prognosis