BACKGROUND Hemorrhoids,a prevalent chronic condition globally,significantly impact patients'quality of life.While various surgical interventions,such as external stripping and internal ligation,procedure for prola...BACKGROUND Hemorrhoids,a prevalent chronic condition globally,significantly impact patients'quality of life.While various surgical interventions,such as external stripping and internal ligation,procedure for prolapse and hemorrhoids,and tissue selecting technique,are employed for treatment,they are often associated with postoperative complications,including unsatisfactory defecation,bleeding,and anal stenosis.In contrast,Xiaozhiling injection,a traditional Chinese medicine-based therapy,has emerged as a minimally invasive and effective alternative for internal hemorrhoids.This treatment offers distinct advantages,such as reduced dietary restrictions,broad applicability,and minimal induction of systemic inflammatory responses.Additionally,Xiaozhiling injection effectively eliminates hemorrhoid nuclei,prevents local tissue necrosis,preserves anal cushion integrity,and mitigates postoperative complications,including bleeding and prolapse.Despite its clinical efficacy,the molecular mechanisms underlying its therapeutic effects remain poorly understood,warranting further investigation.AIM To investigate the molecular mechanism underlying the therapeutic effect of Xiaozhiling injection in the treatment of internal hemorrhoids.METHODS An internal hemorrhoid model was established in rats,and the rats were randomly divided into a modeling group[control group(CK group)]and a treatment group.One week after injection,Stereo-seq and electron microscopy were used to study the changes in gene expression and subcellular structures in fibroblasts.RESULTS Single-cell sequencing revealed differences in the expression and transcript levels of the genes collagen 3 alpha 1,decorin,and actin alpha 2 in fibroblasts between the CK group and the treatment group.Spatial transcriptome analysis revealed that genes of the sphingosine kinase 1(Sphk1)/sphingosine-1-phosphate(S1P)pathway spatially overlapped with key genes of the transforming growth factor beta 1 pathway,namely,Sphk1,S1P receptor,and transforming growth factor beta 1,in the treatment group.The proportion of fibroblasts was lower in the treatment group than in the CK group,and Xiaozhiling treatment had a significant effect on the proportion of fibroblasts in hemorrhoidal tissue.Immunohistochemistry revealed a significant increase in the expression of a fibroblast marker.Electron microscopy showed that the endoplasmic reticulum of fibroblasts contained a large amount of glycogen,indicating cell activation.Fibroblast activation and the expression of key genes of the Sphk1-S1P pathway could be observed at the injection site,suggesting that after Xiaozhiling intervention,the Sphk1-S1P pathway could be activated to promote fibrosis.CONCLUSION Xiaozhiling injection exerts its therapeutic effects on internal hemorrhoids by promoting collagen synthesis and secretion in fibroblasts.After Xiaozhiling intervention,the Sphk1-S1P pathway can be activated to promote fibrosis.展开更多
BACKGROUND Endoscopic rubber band ligation(ERBL)is a nonsurgical technique for the treatment of symptomatic internal hemorrhoids but is limited by recurrence and post-procedural pain.AIM To evaluate satisfaction,long-...BACKGROUND Endoscopic rubber band ligation(ERBL)is a nonsurgical technique for the treatment of symptomatic internal hemorrhoids but is limited by recurrence and post-procedural pain.AIM To evaluate satisfaction,long-term recurrence,and post-procedural pain in managing internal hemorrhoids using a combination of polidocanol foam sclerotherapy and ERBL.METHODS This was a prospective,multicenter,randomized study.A total of 195 consecutive patients diagnosed with grade II-III internal hemorrhoids were enrolled from four tertiary hospitals and randomly divided into a cap-assisted endoscopic polidocanol foam sclerobanding(EFSB)or an ERBL group.All patients were followed-up for 12 months.Symptom-based severity and post-procedural pain were assessed using a hemorrhoid severity score(HSS)and a visual analog scale(VAS).Continuous variables were reported as medians and interquartile range.RESULTS One hundred and ninety-five patients were enrolled,with 98 in the EFSB group.HSS was lower in the EFSB group than in the ERBL group at 8 weeks[4.0(3.0-5.0)vs 5.0(4.0-6.0),P=0.003]and 12-month[2.0(1.0-3.0)vs 3.0(2.0-3.0),P<0.001]of follow-up.The prolapse recurrence rate was lower in the EFSB group at 12 months(11.2%vs 21.6%,P=0.038).Multiple linear regression analysis demonstrated that EFSB treatment[B=-0.915,95%confidence interval(CI):−1.301 to−0.530,P=0.001]and rubber band number(B=0.843,95%CI:0.595-1.092,P<0.001)were negatively and independently associated with the VAS score 24 hours post-procedure.The median VAS was lower in the EFSB group than in the ERBL[2.0(1.0-3.0)vs 3.0(2.0-4.0),P<0.001].CONCLUSION Cap-assisted EFSB provided long-term satisfaction and effective relief from the recurrence of prolapse and pain 24 hours post-procedure.展开更多
BACKGROUND Rubber band ligation(RBL) using rigid anoscope is a commonly recommended therapy for grade Ⅰ-Ⅲ symptomatic internal hemorrhoids. Severe complications of RBL include pain, hemorrhage and sepsis. Flexible e...BACKGROUND Rubber band ligation(RBL) using rigid anoscope is a commonly recommended therapy for grade Ⅰ-Ⅲ symptomatic internal hemorrhoids. Severe complications of RBL include pain, hemorrhage and sepsis. Flexible endoscopic RBL(ERBL) is now more commonly used in RBL therapy but few severe complications have been reported. Here we report on a case of massive bleeding after ERBL.CASE SUMMARY A 31-year-old female was admitted to the department of gastroenterology with a chief complaint of discontinuous hematochezia for 2 years. No previous history, accompanying diseases or drug use was reported. Physical examination and colonoscopy showed grade Ⅱ internal hemorrhoids. The patient received ERBL therapy. Five days after ligation, the patient presented with mild hematochezia. On days 7 and 9 after ligation, she presented with a large amount of rectal bleeding, dizziness and weakness. Emergency colonoscopy revealed active bleeding and an ulcer in the anal wound. The patient received two sessions of hemoclipping on days 7 and 9 to treat the bleeding. No further bleeding was reported up to day 15 and she was discharged home. Although the hemorrhoid prolapse disappeared after ERBL, she was dissatisfied with the subsequent complications.CONCLUSION ERBL therapy is an effective treatment for symptomatic internal hemorrhoids with satisfactory short and long-term recovery. Pain and anal bleeding are the most frequently reported postoperative complications. Coagulation disorders complicate the increased risk of bleeding. Although rarely reported, our case reminds us that those patients without coagulation disorders are also at risk of massive life-threatening bleeding and need strict follow-up after ligation.展开更多
BACKGROUND The hemorrhoid energy treatment(HET)system is a non-surgical bipolar electrotherapy device,which has previously demonstrated efficacy in the management of bleeding Grade I and II internal hemorrhoids;howeve...BACKGROUND The hemorrhoid energy treatment(HET)system is a non-surgical bipolar electrotherapy device,which has previously demonstrated efficacy in the management of bleeding Grade I and II internal hemorrhoids;however,data is limited.AIM To prospectively assess the safety and efficacy of the HET device.METHODS This was an IRB-approved prospective study of 73 patients with Grade I or II internal hemorrhoids who underwent HET from March 2016 to June 2019.Patient factors and procedural data were obtained.A post-procedure questionnaire was administered by telephone to all patients at 1-wk and 3-mo following HET to assess for improvement and/or resolution of rectal bleeding and adherence to a stool softener regimen.A chart review was performed to observe recurrent symptoms and durability of response.Statistical analyses were performed using SPSS software(IBM;SPSS Version 25.0).RESULTS Seventy-three patients underwent HET during the study period.Mean post-HET follow-up was 1.89 years.Complete resolution of bleeding was reported in 65%at 1 wk(n=48),with improvement in bleeding in 97.2%(n=71)of patients.At 3-mo,resolution and/or improvement in bleeding was reported in 90%(n=64)of patients.No procedure-related pain or adverse events were reported.CONCLUSION HET is well tolerated,safe and highly effective in the majority of our patients presenting with Grade I and II symptomatic internal hemorrhoids.展开更多
In the study,we comment on the article by Qu et al.Internal hemorrhoids are the most common anorectal disorders worldwide with bleeding,prolapse,and difficulty in defecation.Endoscopic rubber band ligation(ERBL)is a s...In the study,we comment on the article by Qu et al.Internal hemorrhoids are the most common anorectal disorders worldwide with bleeding,prolapse,and difficulty in defecation.Endoscopic rubber band ligation(ERBL)is a safe,convenient,quick,and economical outpatient procedure.The main goal of ERBL is to alleviate prolapse,but the high incidence of recurrence and post-procedural pain are of clinical concern.Polidocanol foam as a local hemostatic and anesthetic agent could reduce the rates of post-procedural pain and bleeding.Endoscopic polidocanol foam sclerobanding(EFSB)is a novel approach that could lift the mucosa for easy ligation and promote increased scarring in the submucosal tissue which translates into long-term relief from prolapse recurrence and reduced 24-h postprocedural pain.The study by Qu et al is a novel multi-center prospective randomized study to compare ERBL and EFSB in patients with grades II and III internal hemorrhoids with one-year follow-up.Results showed that EFSB is a novel therapy for internal hemorrhoids,but future studies with a larger sample,multiple treatment sessions,and long-term follow-up are required to confirm these findings.展开更多
We have read the article by Qu et al with great interest,as it presents an inte-gration of endoscopic polidocanol foam sclerotherapy with rubber band ligation in patients with Grade Ⅱ-Ⅲ internal hemorrhoids.The auth...We have read the article by Qu et al with great interest,as it presents an inte-gration of endoscopic polidocanol foam sclerotherapy with rubber band ligation in patients with Grade Ⅱ-Ⅲ internal hemorrhoids.The authors conducted a prospective,multicenter,randomized study to evaluate the long-term sympto-matic and endoscopic efficacy of this combined intervention.In this discussion,we focus on the procedural steps of this combined strategy and suggest potential avenues for future research.展开更多
Objective: to evaluate and analyze the effect and value of endoscopic sclerotherapy with polidocanol alcohol for internal hemorrhoids. Methods: 80 patients with internal hemorrhoids admitted to our hospital from April...Objective: to evaluate and analyze the effect and value of endoscopic sclerotherapy with polidocanol alcohol for internal hemorrhoids. Methods: 80 patients with internal hemorrhoids admitted to our hospital from April 2021 to April 2022 were randomly divided into the experimental group and the reference group (40 cases in each group) by double-blind method. The reference group was treated with conventional surgery, while the experimental group was treated with sclerosing agent of polyglycerol under endoscope. The therapeutic effects, pain conditions at different stages after treatment, perioperative inflammatory status indicators and perioperative complication rate of the two groups were statistically compared. Results: after treatment, the total effective rate of the experimental group was higher than that of the reference group, the VAS score of the experimental group was lower than that of the reference group at different stages in the early postoperative period, the inflammatory indexes such as CRP and PCT of the experimental group were lower than that of the reference group at 7 days after operation, and the perioperative incidence rate was lower than that of the reference group, with statistical significance (p 0.05). Conclusion: the curative effect of endoscopic sclerotherapy with poly (laurel alcohol) for internal hemorrhoids patients is definite, the postoperative pain response is relatively mild, and it is helpful to promote the improvement of postoperative inflammatory state and reduce the risk of complications.展开更多
Objective: to evaluate the clinical efficacy and safety of linked color imaging (LCI) combined with postoperative finger massage under gastroscope for internal hemorrhoids. Methods: a total of 60 patients undergoing e...Objective: to evaluate the clinical efficacy and safety of linked color imaging (LCI) combined with postoperative finger massage under gastroscope for internal hemorrhoids. Methods: a total of 60 patients undergoing endoscopic sclerotherapy for internal hemorrhoids in Yichang Central Peoples Hospital from June 2020 to September 2021 were randomly divided into study (LCI) group (n 30) and control (WLE) group (n 30). Under the gastroscope imaging mode (LCI) and ordinary white light endoscopy (WLE) respectively, use a gastroscope with a transparent cap to add a small amount of methylene blue tracer into the polylol stock solution and inject it into the hemorrhoid nucleus at different points, so as to observe that the tracer will immediately stop the injection. If there is a small amount of hemorrhage after the injection, an additional injection of about 0.5 mL can be made. Routine injection will be carried out at 4-5 points, with the total amount not exceeding 10ml. In LCI group, the fingers will be massaged for about 30s after the operation. The symptoms and complications of rebleeding and internal hemorrhoid prolapse within 6 months after operation were compared between the two groups. Results: in the study (LCI) group, 1.0ml and 4.5ml;Of dailyl alcohol were injected at each point on average. The control (WLE) group received an average of 1.5ml of polyglycerol at each point, with a total amount of 7.0ml. During the follow-up period of 6 months after operation, there was no rebleeding in both groups. In the LCI group, there were 10 cases of postoperative anal distension, slight pain and 3 cases of internal hemorrhoid prolapse, but they were significantly better than before. In the WLE group, there were 24 cases of postoperative anal distension, slight pain and 3 cases of internal hemorrhoid prolapse, but except for a small part of anal distension and slight pain, the rest all disappeared spontaneously in 1 to 2 weeks without serious complications such as anal stenosis, gastrointestinal hemorrhage and perforation Conclusion: gastroscopic sclerotherapy for internal hemorrhoids is simple, safe and reliable, with satisfactory curative effect. Compared with white light mode, LCI mode can accurately inject into the hemorrhoid nucleus to reduce the injection amount of polyglycerol at each point. Finger massage can increase the penetration of sclerosant into the hemorrhoid nucleus, thus improving the curative effect, reducing the occurrence of complications and improving postoperative comfort. It is worthy of clinical application.展开更多
Objective： To compare the effect of An＇s Shaobei Injection （安氏芍倍注射液） with Xiaozhiling Injection （消痔灵注射液） in patients with internal hemorrhoids of grade 1-11I. Methods： This cohort study included 1,...Objective： To compare the effect of An＇s Shaobei Injection （安氏芍倍注射液） with Xiaozhiling Injection （消痔灵注射液） in patients with internal hemorrhoids of grade 1-11I. Methods： This cohort study included 1,520 internal hemorrhoids patients with grade Ⅰ-Ⅲ who were scheduled for liquid injection treatment from July 2003 to July 2009. The cohort included patients who underwent either An＇s Shaobei Injection treatment （the treatment group, 760 cases） or Xiaozhiling Injection treatment （the control group, 760 cases）. All patients were followed up regularly for 3 years; the observing indices included anal function recovery and clinical response after operation. Results： Among the 1,520 patients, 1,508 （99.2%） completed the 3-year follow-up. The efficacy rate was 97.5% in the treatment group, significantly higher than the control group （91.8%, P〈0.01）. The recurrence rate in the treatment group was 0.5%, significantly lower than that of the control group （1.3%, P〈0.01）. In addition, perianal callosity occurred in 8 cases （1.1%） and anorectal stricture in 26 cases （3.5%） after operation in the control group. There was no perianal callosity and anorectal stricture in the treatment group. Conclusion： The treatment with An＇s Shaobei Injection demonstrated superior clinical effect to Xiaozhiling Injection with fewer adverse effects.展开更多
基金Supported by the National Natural Science Foundation of China,No.81774118the Foreign Cooperation Project of Science and Technology Department of Fujian Province,No.2023I0021the Medical Innovation Project of Fujian Province,No.2024CXB013.
文摘BACKGROUND Hemorrhoids,a prevalent chronic condition globally,significantly impact patients'quality of life.While various surgical interventions,such as external stripping and internal ligation,procedure for prolapse and hemorrhoids,and tissue selecting technique,are employed for treatment,they are often associated with postoperative complications,including unsatisfactory defecation,bleeding,and anal stenosis.In contrast,Xiaozhiling injection,a traditional Chinese medicine-based therapy,has emerged as a minimally invasive and effective alternative for internal hemorrhoids.This treatment offers distinct advantages,such as reduced dietary restrictions,broad applicability,and minimal induction of systemic inflammatory responses.Additionally,Xiaozhiling injection effectively eliminates hemorrhoid nuclei,prevents local tissue necrosis,preserves anal cushion integrity,and mitigates postoperative complications,including bleeding and prolapse.Despite its clinical efficacy,the molecular mechanisms underlying its therapeutic effects remain poorly understood,warranting further investigation.AIM To investigate the molecular mechanism underlying the therapeutic effect of Xiaozhiling injection in the treatment of internal hemorrhoids.METHODS An internal hemorrhoid model was established in rats,and the rats were randomly divided into a modeling group[control group(CK group)]and a treatment group.One week after injection,Stereo-seq and electron microscopy were used to study the changes in gene expression and subcellular structures in fibroblasts.RESULTS Single-cell sequencing revealed differences in the expression and transcript levels of the genes collagen 3 alpha 1,decorin,and actin alpha 2 in fibroblasts between the CK group and the treatment group.Spatial transcriptome analysis revealed that genes of the sphingosine kinase 1(Sphk1)/sphingosine-1-phosphate(S1P)pathway spatially overlapped with key genes of the transforming growth factor beta 1 pathway,namely,Sphk1,S1P receptor,and transforming growth factor beta 1,in the treatment group.The proportion of fibroblasts was lower in the treatment group than in the CK group,and Xiaozhiling treatment had a significant effect on the proportion of fibroblasts in hemorrhoidal tissue.Immunohistochemistry revealed a significant increase in the expression of a fibroblast marker.Electron microscopy showed that the endoplasmic reticulum of fibroblasts contained a large amount of glycogen,indicating cell activation.Fibroblast activation and the expression of key genes of the Sphk1-S1P pathway could be observed at the injection site,suggesting that after Xiaozhiling intervention,the Sphk1-S1P pathway could be activated to promote fibrosis.CONCLUSION Xiaozhiling injection exerts its therapeutic effects on internal hemorrhoids by promoting collagen synthesis and secretion in fibroblasts.After Xiaozhiling intervention,the Sphk1-S1P pathway can be activated to promote fibrosis.
基金Supported by the Hospital Funded Clinical Research of Xinhua Hospital,No.19XHCR16D.
文摘BACKGROUND Endoscopic rubber band ligation(ERBL)is a nonsurgical technique for the treatment of symptomatic internal hemorrhoids but is limited by recurrence and post-procedural pain.AIM To evaluate satisfaction,long-term recurrence,and post-procedural pain in managing internal hemorrhoids using a combination of polidocanol foam sclerotherapy and ERBL.METHODS This was a prospective,multicenter,randomized study.A total of 195 consecutive patients diagnosed with grade II-III internal hemorrhoids were enrolled from four tertiary hospitals and randomly divided into a cap-assisted endoscopic polidocanol foam sclerobanding(EFSB)or an ERBL group.All patients were followed-up for 12 months.Symptom-based severity and post-procedural pain were assessed using a hemorrhoid severity score(HSS)and a visual analog scale(VAS).Continuous variables were reported as medians and interquartile range.RESULTS One hundred and ninety-five patients were enrolled,with 98 in the EFSB group.HSS was lower in the EFSB group than in the ERBL group at 8 weeks[4.0(3.0-5.0)vs 5.0(4.0-6.0),P=0.003]and 12-month[2.0(1.0-3.0)vs 3.0(2.0-3.0),P<0.001]of follow-up.The prolapse recurrence rate was lower in the EFSB group at 12 months(11.2%vs 21.6%,P=0.038).Multiple linear regression analysis demonstrated that EFSB treatment[B=-0.915,95%confidence interval(CI):−1.301 to−0.530,P=0.001]and rubber band number(B=0.843,95%CI:0.595-1.092,P<0.001)were negatively and independently associated with the VAS score 24 hours post-procedure.The median VAS was lower in the EFSB group than in the ERBL[2.0(1.0-3.0)vs 3.0(2.0-4.0),P<0.001].CONCLUSION Cap-assisted EFSB provided long-term satisfaction and effective relief from the recurrence of prolapse and pain 24 hours post-procedure.
文摘BACKGROUND Rubber band ligation(RBL) using rigid anoscope is a commonly recommended therapy for grade Ⅰ-Ⅲ symptomatic internal hemorrhoids. Severe complications of RBL include pain, hemorrhage and sepsis. Flexible endoscopic RBL(ERBL) is now more commonly used in RBL therapy but few severe complications have been reported. Here we report on a case of massive bleeding after ERBL.CASE SUMMARY A 31-year-old female was admitted to the department of gastroenterology with a chief complaint of discontinuous hematochezia for 2 years. No previous history, accompanying diseases or drug use was reported. Physical examination and colonoscopy showed grade Ⅱ internal hemorrhoids. The patient received ERBL therapy. Five days after ligation, the patient presented with mild hematochezia. On days 7 and 9 after ligation, she presented with a large amount of rectal bleeding, dizziness and weakness. Emergency colonoscopy revealed active bleeding and an ulcer in the anal wound. The patient received two sessions of hemoclipping on days 7 and 9 to treat the bleeding. No further bleeding was reported up to day 15 and she was discharged home. Although the hemorrhoid prolapse disappeared after ERBL, she was dissatisfied with the subsequent complications.CONCLUSION ERBL therapy is an effective treatment for symptomatic internal hemorrhoids with satisfactory short and long-term recovery. Pain and anal bleeding are the most frequently reported postoperative complications. Coagulation disorders complicate the increased risk of bleeding. Although rarely reported, our case reminds us that those patients without coagulation disorders are also at risk of massive life-threatening bleeding and need strict follow-up after ligation.
文摘BACKGROUND The hemorrhoid energy treatment(HET)system is a non-surgical bipolar electrotherapy device,which has previously demonstrated efficacy in the management of bleeding Grade I and II internal hemorrhoids;however,data is limited.AIM To prospectively assess the safety and efficacy of the HET device.METHODS This was an IRB-approved prospective study of 73 patients with Grade I or II internal hemorrhoids who underwent HET from March 2016 to June 2019.Patient factors and procedural data were obtained.A post-procedure questionnaire was administered by telephone to all patients at 1-wk and 3-mo following HET to assess for improvement and/or resolution of rectal bleeding and adherence to a stool softener regimen.A chart review was performed to observe recurrent symptoms and durability of response.Statistical analyses were performed using SPSS software(IBM;SPSS Version 25.0).RESULTS Seventy-three patients underwent HET during the study period.Mean post-HET follow-up was 1.89 years.Complete resolution of bleeding was reported in 65%at 1 wk(n=48),with improvement in bleeding in 97.2%(n=71)of patients.At 3-mo,resolution and/or improvement in bleeding was reported in 90%(n=64)of patients.No procedure-related pain or adverse events were reported.CONCLUSION HET is well tolerated,safe and highly effective in the majority of our patients presenting with Grade I and II symptomatic internal hemorrhoids.
文摘In the study,we comment on the article by Qu et al.Internal hemorrhoids are the most common anorectal disorders worldwide with bleeding,prolapse,and difficulty in defecation.Endoscopic rubber band ligation(ERBL)is a safe,convenient,quick,and economical outpatient procedure.The main goal of ERBL is to alleviate prolapse,but the high incidence of recurrence and post-procedural pain are of clinical concern.Polidocanol foam as a local hemostatic and anesthetic agent could reduce the rates of post-procedural pain and bleeding.Endoscopic polidocanol foam sclerobanding(EFSB)is a novel approach that could lift the mucosa for easy ligation and promote increased scarring in the submucosal tissue which translates into long-term relief from prolapse recurrence and reduced 24-h postprocedural pain.The study by Qu et al is a novel multi-center prospective randomized study to compare ERBL and EFSB in patients with grades II and III internal hemorrhoids with one-year follow-up.Results showed that EFSB is a novel therapy for internal hemorrhoids,but future studies with a larger sample,multiple treatment sessions,and long-term follow-up are required to confirm these findings.
文摘We have read the article by Qu et al with great interest,as it presents an inte-gration of endoscopic polidocanol foam sclerotherapy with rubber band ligation in patients with Grade Ⅱ-Ⅲ internal hemorrhoids.The authors conducted a prospective,multicenter,randomized study to evaluate the long-term sympto-matic and endoscopic efficacy of this combined intervention.In this discussion,we focus on the procedural steps of this combined strategy and suggest potential avenues for future research.
文摘Objective: to evaluate and analyze the effect and value of endoscopic sclerotherapy with polidocanol alcohol for internal hemorrhoids. Methods: 80 patients with internal hemorrhoids admitted to our hospital from April 2021 to April 2022 were randomly divided into the experimental group and the reference group (40 cases in each group) by double-blind method. The reference group was treated with conventional surgery, while the experimental group was treated with sclerosing agent of polyglycerol under endoscope. The therapeutic effects, pain conditions at different stages after treatment, perioperative inflammatory status indicators and perioperative complication rate of the two groups were statistically compared. Results: after treatment, the total effective rate of the experimental group was higher than that of the reference group, the VAS score of the experimental group was lower than that of the reference group at different stages in the early postoperative period, the inflammatory indexes such as CRP and PCT of the experimental group were lower than that of the reference group at 7 days after operation, and the perioperative incidence rate was lower than that of the reference group, with statistical significance (p 0.05). Conclusion: the curative effect of endoscopic sclerotherapy with poly (laurel alcohol) for internal hemorrhoids patients is definite, the postoperative pain response is relatively mild, and it is helpful to promote the improvement of postoperative inflammatory state and reduce the risk of complications.
文摘Objective: to evaluate the clinical efficacy and safety of linked color imaging (LCI) combined with postoperative finger massage under gastroscope for internal hemorrhoids. Methods: a total of 60 patients undergoing endoscopic sclerotherapy for internal hemorrhoids in Yichang Central Peoples Hospital from June 2020 to September 2021 were randomly divided into study (LCI) group (n 30) and control (WLE) group (n 30). Under the gastroscope imaging mode (LCI) and ordinary white light endoscopy (WLE) respectively, use a gastroscope with a transparent cap to add a small amount of methylene blue tracer into the polylol stock solution and inject it into the hemorrhoid nucleus at different points, so as to observe that the tracer will immediately stop the injection. If there is a small amount of hemorrhage after the injection, an additional injection of about 0.5 mL can be made. Routine injection will be carried out at 4-5 points, with the total amount not exceeding 10ml. In LCI group, the fingers will be massaged for about 30s after the operation. The symptoms and complications of rebleeding and internal hemorrhoid prolapse within 6 months after operation were compared between the two groups. Results: in the study (LCI) group, 1.0ml and 4.5ml;Of dailyl alcohol were injected at each point on average. The control (WLE) group received an average of 1.5ml of polyglycerol at each point, with a total amount of 7.0ml. During the follow-up period of 6 months after operation, there was no rebleeding in both groups. In the LCI group, there were 10 cases of postoperative anal distension, slight pain and 3 cases of internal hemorrhoid prolapse, but they were significantly better than before. In the WLE group, there were 24 cases of postoperative anal distension, slight pain and 3 cases of internal hemorrhoid prolapse, but except for a small part of anal distension and slight pain, the rest all disappeared spontaneously in 1 to 2 weeks without serious complications such as anal stenosis, gastrointestinal hemorrhage and perforation Conclusion: gastroscopic sclerotherapy for internal hemorrhoids is simple, safe and reliable, with satisfactory curative effect. Compared with white light mode, LCI mode can accurately inject into the hemorrhoid nucleus to reduce the injection amount of polyglycerol at each point. Finger massage can increase the penetration of sclerosant into the hemorrhoid nucleus, thus improving the curative effect, reducing the occurrence of complications and improving postoperative comfort. It is worthy of clinical application.
文摘Objective： To compare the effect of An＇s Shaobei Injection （安氏芍倍注射液） with Xiaozhiling Injection （消痔灵注射液） in patients with internal hemorrhoids of grade 1-11I. Methods： This cohort study included 1,520 internal hemorrhoids patients with grade Ⅰ-Ⅲ who were scheduled for liquid injection treatment from July 2003 to July 2009. The cohort included patients who underwent either An＇s Shaobei Injection treatment （the treatment group, 760 cases） or Xiaozhiling Injection treatment （the control group, 760 cases）. All patients were followed up regularly for 3 years; the observing indices included anal function recovery and clinical response after operation. Results： Among the 1,520 patients, 1,508 （99.2%） completed the 3-year follow-up. The efficacy rate was 97.5% in the treatment group, significantly higher than the control group （91.8%, P〈0.01）. The recurrence rate in the treatment group was 0.5%, significantly lower than that of the control group （1.3%, P〈0.01）. In addition, perianal callosity occurred in 8 cases （1.1%） and anorectal stricture in 26 cases （3.5%） after operation in the control group. There was no perianal callosity and anorectal stricture in the treatment group. Conclusion： The treatment with An＇s Shaobei Injection demonstrated superior clinical effect to Xiaozhiling Injection with fewer adverse effects.
