Treatment of Grade Ⅱ and Ⅲ Internal Hemorrhoids with Doppler-Guided Hemorrhoidal Artery Ligation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

孟庆辉 ,  王子恒 , 李林强 , 梁德森

Corresponding author：

王子恒, Email: doctorwang1984@yahoo.cn

Keywords：

多普勒; 痔上动脉; 内痔

Video：

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目的评估多普勒超声引导的痔上动脉结扎治疗Ⅱ、Ⅲ度内痔的临床应用价值。方法对2009 年4～9月期间在我科行多普勒超声引导的痔上动脉结扎的49 例Ⅱ、Ⅲ度内痔患者从术后肛门括约肌功能、症状有效改善情况、疼痛程度及完全恢复正常生活所需时间方面进行评价。结果术后无患者出现肛门括约肌功能失调；术后1 周、1 个月及3 个月Ⅱ、Ⅲ度内痔分别有77.8%(42/54)、87.0%(47/54)、92.6%(50/54)和59.4%(19/32)、71.9%(23/32)、78.1%(25/32)的患者单项症状得到有效改善；术后6 h及24 h VAS 法疼痛程度评分平均分分别为1.95分和1.63分；患者完全恢复正常生活所需时间平均为术后2.98 d。结论多普勒超声引导的痔上动脉结扎治疗Ⅱ、Ⅲ度内痔安全有效，术后疼痛较轻且可以较快地完全恢复正常生活。

Citation： 孟庆辉,王子恒,李林强,梁德森. Treatment of Grade Ⅱ and Ⅲ Internal Hemorrhoids with Doppler-Guided Hemorrhoidal Artery Ligation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(12): 1308-1309. doi: Copy

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2.	中华医学会外科学分会结直肠肛门外科学组、中华中医药学会肛肠病专业委员会、中国中西医结合学会结直肠肛门病专业委员会. 痔临床诊治指南(2006 版) [J]. 中华胃肠外科杂志, 2006； 9(5): 461-463.
3.	吴在德, 吴肇汉. 外科学 [M]. 第6版，北京：人民卫生出版社， 2005： 129.
4.	Bursics A, Morvay K, Kupcsulik P, et al. Comparison of early and 1-year follow-up results of conventional hemorrhoidectomy and hemorrhoid artery ligation: a randomized study [J]. Int J Colorectal Dis, 2004； 19(2): 176-180.
5.	Wallis de Vries BM, van der Beek ES, de Wijkerslooth LR, et al. Treatment of Grade 2 and 3 Hemorrhoids with Doppler-Guided Hemorrhoidal Artery Ligation [J]. Dig Surg, 2007； 24(6): 436-440.
6.	Scheyer M, Antonietti E, Rollinger G, et al. Doppler-guided hemorrhoidal artery ligation [J]. Am J Surg, 2006； 191(1): 89-93.
7.	Greenberg R, Karin E, Avital S, et al. First 100 cases with Doppler-guided hemorrhoidal artery ligation [J]. Dis Colon Rectum, 2006； 49(4): 485-489.
8.	Felice G, Privitera A, Ellul E, et al. Doppler-guided hemorrhoidal artery ligation: an alternative to hemorrhoidectomy [J]. Dis Colon Rectum, 2005； 48(11): 2090-2093.
9.	Walega P, Scheyer M, Kenig J, et al. Two-center experience in the treatment of hemorrhoidal disease using Doppler-guided hemorrhoidal artery ligation: functional results after 1-year follow-up [J]. Surg Endosc, 2008； 22(11): 2379-2383.
10.	Shanmugam V, Thaha MA, Rabindranath KS, et al. Systematic review of randomized trials comparing rubber band ligation with excisional haemorrhoidectomy [J]. Br J Surg, 2005； 92(12): 1481-1487.
11.	Komborozos VA, Skrekas GJ, Pissiotis CA. Rubber band ligation of symptomatic internal hemorrhoids: results of 500 cases [J]. Dig Surg, 2000； 17(1): 71-76.
12.	Ortiz H, Marzo J, Armendariz P. Randomized clinical trial of stapled haemorrhoidopexy versus conventional diathermy haemorrhoidectomy [J]. Br J Surg, 2002; 89(11): 1376-1381.
13.	Longo A. Treatment of hemorrhoids disease by reduction of mucosa and hemorrhoidal prolapse with a circular suturing device: a new procedure [A]. In: Proceedings of the 6th World Congress of Endoscopic Surgery [M]. Bologna, Italy: Monduzzi Editore, 1998: 777-784.
14.	Molloy RG, Kingsmore D. Life threatening pelvic sepsis after stapled haemorrhoidectomy [J]. Lancet, 2000； 355(9206): 810.

1. Morinaga K, Hasuda K, Ikeda T. A novel therapy for internal hemorrhoids: ligation of the hemorrhoidal artery with a newly devised instrument (Moricorn) in conjunction with a Doppler flowmeter [J]. Am J Gastroenterol， 1995； 90(4): 610-613.
2. 中华医学会外科学分会结直肠肛门外科学组、中华中医药学会肛肠病专业委员会、中国中西医结合学会结直肠肛门病专业委员会. 痔临床诊治指南(2006 版) [J]. 中华胃肠外科杂志, 2006； 9(5): 461-463.
3. 吴在德, 吴肇汉. 外科学 [M]. 第6版，北京：人民卫生出版社， 2005： 129.
4. Bursics A, Morvay K, Kupcsulik P, et al. Comparison of early and 1-year follow-up results of conventional hemorrhoidectomy and hemorrhoid artery ligation: a randomized study [J]. Int J Colorectal Dis, 2004； 19(2): 176-180.
5. Wallis de Vries BM, van der Beek ES, de Wijkerslooth LR, et al. Treatment of Grade 2 and 3 Hemorrhoids with Doppler-Guided Hemorrhoidal Artery Ligation [J]. Dig Surg, 2007； 24(6): 436-440.
6. Scheyer M, Antonietti E, Rollinger G, et al. Doppler-guided hemorrhoidal artery ligation [J]. Am J Surg, 2006； 191(1): 89-93.
7. Greenberg R, Karin E, Avital S, et al. First 100 cases with Doppler-guided hemorrhoidal artery ligation [J]. Dis Colon Rectum, 2006； 49(4): 485-489.
8. Felice G, Privitera A, Ellul E, et al. Doppler-guided hemorrhoidal artery ligation: an alternative to hemorrhoidectomy [J]. Dis Colon Rectum, 2005； 48(11): 2090-2093.
9. Walega P, Scheyer M, Kenig J, et al. Two-center experience in the treatment of hemorrhoidal disease using Doppler-guided hemorrhoidal artery ligation: functional results after 1-year follow-up [J]. Surg Endosc, 2008； 22(11): 2379-2383.
10. Shanmugam V, Thaha MA, Rabindranath KS, et al. Systematic review of randomized trials comparing rubber band ligation with excisional haemorrhoidectomy [J]. Br J Surg, 2005； 92(12): 1481-1487.
11. Komborozos VA, Skrekas GJ, Pissiotis CA. Rubber band ligation of symptomatic internal hemorrhoids: results of 500 cases [J]. Dig Surg, 2000； 17(1): 71-76.
12. Ortiz H, Marzo J, Armendariz P. Randomized clinical trial of stapled haemorrhoidopexy versus conventional diathermy haemorrhoidectomy [J]. Br J Surg, 2002; 89(11): 1376-1381.
13. Longo A. Treatment of hemorrhoids disease by reduction of mucosa and hemorrhoidal prolapse with a circular suturing device: a new procedure [A]. In: Proceedings of the 6th World Congress of Endoscopic Surgery [M]. Bologna, Italy: Monduzzi Editore, 1998: 777-784.
14. Molloy RG, Kingsmore D. Life threatening pelvic sepsis after stapled haemorrhoidectomy [J]. Lancet, 2000； 355(9206): 810.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Treatment of Grade Ⅱ and Ⅲ Internal Hemorrhoids with Doppler-Guided Hemorrhoidal Artery Ligation

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