自动痔疮套扎术联合消痔灵、藻酸盐粉治疗Ⅲ度混合痔的临床疗效

Clinical effect of automatic hemorrhoid ligation combined with Xiaozhiling and alginate powder on grade Ⅲ mixed hemorrhoids

摘要:

目的 探讨自动痔疮套扎术联合消痔灵、藻酸盐粉治疗Ⅲ度混合痔的临床疗效。方法 选取2022年6月—2023年5月空军特色医学中心收治的84例Ⅲ度混合痔患者，按照不同治疗方法分为对照组与研究组，每组42例。对照组行自动痔疮套扎术联合消痔灵治疗，研究组在对照组的基础上加用藻酸盐粉。观察两组的临床疗效、恢复情况、并发症及术后3、7、12 d的创面愈合率，统计并比较两组治疗前与治疗3周后的肿瘤坏死因子-α（TNF-α）、白细胞介素-8（IL-8）、转化生长因子-β₁（TGF-β₁）水平。结果 研究组总有效率高于对照组（P <0.05）。研究组治疗前后TNF-α、IL-8、TGF-β₁水平差值均高于对照组（P <0.05）。研究组肛门水肿、出血及渗液的消失时间、创面愈合时间均短于对照组（P <0.05）。研究组与对照组术后3、7、12 d的创面愈合率比较，结果 ①不同时间点创面愈合率比较，差异有统计学意义（P <0.05）；②研究组与对照组的创面愈合率比较，差异有统计学意义（P <0.05），与对照组相比，研究组的创面愈合率较高，相对愈合效果较好；③研究组与对照组的创面愈合率变化趋势比较，差异有统计学意义（P <0.05）。两组并发症发生率比较，差异无统计学意义（P >0.05）。结论 自动痔疮套扎术联合消痔灵、藻酸盐粉治疗，可促进术后的恢复和创面的愈合，更好地减轻炎症反应，提高疗效，且安全性良好。

Abstract:

Objective To evaluate the clinical efficacy of automated hemorrhoid ligation combined with Xiaozhilin and alginate powder in the treatment of Grade Ⅲ mixed hemorrhoids.Methods A total of 84 patients with Grade Ⅲ mixed hemorrhoids admitted to the Air Force Medical Center from June 2022 to May 2023 were selected. They were randomly divided into two groups: the control group and the study group. The control group received automated hemorrhoid ligation combined with Xiaozhilin, while the study group received the same treatment plus alginate powder. The clinical efficacy, recovery status, complications, and wound healing rates at 3, 7 and 12 days post-surgery were observed. The levels of tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8), and transforming growth factor-β₁ (TGF-β₁) were compared before treatment and at 3 weeks post-treatment.Results The total effective rate in the study group was higher than that in the control group (P < 0.05). The differences in TNF-α, IL-8, and TGF-β₁ levels before and after treatment in the study group were greater than those in the control group (P < 0.05). The study group had shorter times for the disappearance of anal edema, bleeding, and exudation, as well as a shorter wound healing time compared to the control group (P < 0.05). The comparison of wound healing rates between the study and control groups at 3, 7 and 12 days post-surgery showed significant differences,specifically: 1) Significant differences were observed at different time points (P < 0.05); 2) The study group had higher wound healing rates compared to the control group (P < 0.05), indicating better healing; 3) The trends in wound healing rate changes were significantly different between the two groups (P < 0.05). There were no significant differences in the incidence of complications between the two groups (P > 0.05).Conclusion Automated hemorrhoid ligation combined with Xiaozhilin and alginate powder promotes postoperative recovery and wound healing, reduces inflammatory responses, and improves efficacy, with good safety.