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Clinical observation on prognosis of mixed hemorrhoids treated with polidocanol injection combined with automatic elastic thread ligation operation 被引量:3
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作者 Yan-Mei Huang Dong Ouyang 《World Journal of Gastrointestinal Surgery》 2025年第1期209-216,共8页
BACKGROUND A total of 100 patients diagnosed with mixed hemorrhoids from October 2022 to September 2023 in our hospital were randomly divided into groups by dice rolling and compared with the efficacy of different tre... BACKGROUND A total of 100 patients diagnosed with mixed hemorrhoids from October 2022 to September 2023 in our hospital were randomly divided into groups by dice rolling and compared with the efficacy of different treatment options.AIM To analyze the clinical effect and prognosis of mixed hemorrhoids treated with polidocanol injection combined with automatic elastic thread ligation operation(RPH).METHODS A total of 100 patients with mixed hemorrhoids who visited our hospital from October 2022 to September 2023 were selected and randomly divided into the control group(n=50)and the treatment group(n=50)by rolling the dice.The procedure for prolapse and hemorrhoids(PPH)was adopted in the control group,while polidocanol foam injection+RPH was adopted in the treatment group.The therapeutic effects,operation time,wound healing time,hospital stay,pain situation(24 hours post-operative pain score,first defecation pain score),quality of life(QOL),incidence of complications(post-operative hemorrhage,edema,infection),incidence of anal stenosis 3 months post-operatively and recurrence rate 1 year post-operatively of the two groups were compared.RESULTS Compared with the control group,the total effective rate of treatment group was higher,and the difference was significant(P<0.05).The operation time/wound healing time/hospital stay in the treatment group were shorter than those in the control group(P<0.05).The pain scores at 24 hours after operation/first defecation pain score of the treatment group was significantly lower than those in the control group(P<0.05).After surgery,the QOL scores of the two groups decreased,with the treatment group having higher scores than that of the control group(P<0.05).Compared with the control group,the incidence of postoperative complications in the treatment group was lower,and the difference was significant(P<0.05);However,there was no significant difference in the incidence of postoperative bleeding between the two groups(P>0.05);There was no significant difference in the incidence of anal stenosis 3 months after operation and the recurrence rate 1 year after operation between the two groups(P>0.05).CONCLUSION For patients with mixed hemorrhoids,the therapeutic effect achieved by using polidocanol injection combined with RPH was better.The wounds of the patients healed faster,the postoperative pain was milder,QOL improved,and the incidence of complications was lower,and the short-term and long-term prognosis was good. 展开更多
关键词 Mixed hemorrhoids Polidocanol injection Automatic elastic thread ligation operation Postoperative hemorrhage The degree of pain Recurrent rate
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Sclerotherapy for hemorrhoidal disease:Recent evolutions of an oldies goldy
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作者 Gianpiero Gravante 《World Journal of Gastroenterology》 2025年第8期140-143,共4页
Treatments for low degree hemorrhoids(I-III degree)are numerous and so are their counterparts for higher degrees.These treatments present nebulous diffe-rences in terms of indications and outcomes among techniques.Met... Treatments for low degree hemorrhoids(I-III degree)are numerous and so are their counterparts for higher degrees.These treatments present nebulous diffe-rences in terms of indications and outcomes among techniques.Methods previously abandoned due to side effects and long-term results have recently rejoined the mainstream due to recent peculiar modifications:Hemorrhoidal sclerotherapy is enjoying a new age of interest due to the use of the foam form of polidocanol,which is more effective than the liquid one.Various articles have already shown promising results and the logical next step is the combination of polidocanol foam with rubber-band ligation(the historical counterpart of sclero-therapy)in a technique called“sclerobanding”.In this article,we comment on the publication by Qu et al further modifying the use of sclerobanding through an endoscopic delivery for patients with grade II-III internal hemorrhoids,and present results compared with endoscopic rubber band ligation.The results achieved are promising. 展开更多
关键词 Three percent polidocanol foam Bleeding hemorrhoids hemorrhoidal disease SCLEROTHERAPY Symptomatic hemorrhoids
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Comparative analysis of Ferguson hemorrhoidectomy combined with doppler-guided hemorrhoidal artery ligation and Ferguson hemorrhoidectomy in hemorrhoidal disease treatment
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作者 Ismail Cem Eray Ugur Topal +3 位作者 Serdar Gumus Kubilay Isiker Burak Yavuz Ishak Aydin 《World Journal of Gastrointestinal Surgery》 2025年第3期323-330,共8页
BACKGROUND In hemorrhoidal disease,despite the existence of numerous treatment options to alleviate symptoms,surgical intervention continues to be the gold standard.The advantages and disadvantages of many methods hav... BACKGROUND In hemorrhoidal disease,despite the existence of numerous treatment options to alleviate symptoms,surgical intervention continues to be the gold standard.The advantages and disadvantages of many methods have been shown in numerous studies However,only a few studies have compared the effectiveness of combined methods.AIM To compare the results of a coloproctology clinic that switched to the Doppler-guided hemorrhoidal artery ligation(DG-HAL)+Ferguson hemorrhoidectomy(FH)technique from the FH in the treatment of hemorrhoidal disease.METHODS In this retrospective cohort,data from a total of 45 patients who underwent DG-HAL+FH(n=24)and FH(n=21)for grade III hemorrhoidal disease between 2020 and 2022 were analyzed.Demographic and clinical data,surgical duration,intraoperative blood loss,hospital stay,postoperative analgesic consumption,pain scores using the Visual Analog Scale(VAS),complications,time to return to normal activities,and the recurrence rate were compared in both groups.RESULTS The study included 45 patients,with 75.6%(n=34)male and 24.4%(n=11)female.The rate of intraoperative blood loss was higher in the FH group(P<0.05).The VAS scores and postoperative complication rates were similar in both groups.The need for postoperative analgesics was lower in the DG-HAL+FH group(2 vs 4 days,P<0.05),while the FH group showed a shorter time to return to normal activities(9.5 vs 6.0 days,P=0.02).The recurrence rate(16.7%vs 0%)and Clavien–Dindo Score-1 complications(20.8%vs 9.5%,P=0.29)were higher in the DG-HAL+FH group but were insignificant.CONCLUSION Our study revealed that the addition of the DG-HAL to classical hemorrhoidectomy caused less intraoperative bleeding and a lower postoperative analgesia requirement. 展开更多
关键词 hemorrhoidal disease Doppler-guided hemorrhoidal artery ligation Ferguson hemorrhoidectomy Postoperative pain RECURRENCE
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Analysis of recurrence after stapled hemorrhoidopexy in grade IV hemorrhoid disease
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作者 Ahmet Erkek Muhammed K Yıldırak +1 位作者 Abdullah Yıldız BarışSevinç 《World Journal of Gastrointestinal Surgery》 2025年第8期230-235,共6页
BACKGROUND Stapled hemorrhoidopexy(SH)is one of the most commonly used surgical techniques for hemorrhoidal disease,being particularly effective for grade III and IV hemorrhoids.The procedure is associated with better... BACKGROUND Stapled hemorrhoidopexy(SH)is one of the most commonly used surgical techniques for hemorrhoidal disease,being particularly effective for grade III and IV hemorrhoids.The procedure is associated with better short-term outcomes,including less postoperative pain,shorter operative time,faster return to work,and higher patient satisfaction.However,there is a risk-benefit debate surrounding SH due to significant complications from the procedure,such as anal stenosis,rectovaginal fistula,fecal incontinence,and recurrence.AIM To evaluate recurrence rates and factors influencing surgical outcomes following SH in patients with grade III and IV hemorrhoids.METHODS This retrospective,single-center study enrolled a total of 77 patients with grade III/IV hemorrhoids for analysis.Early(less than 7 days after SH)and late(7 or more days after SH)complications were analyzed.Recurrence rates were calculated as well.RESULTS Patients were categorized by hemorrhoid grade and showed no differences in demographic data between the two groups.Recurrence was observed in 4 patients(23.6%)with grade IV hemorrhoids,and no recurrence was noted in patients with grade III hemorrhoids.Postoperative bleeding,incomplete defecation,urgent defecation,incontinence,skin tags,and anal fissure were complications reported by both groups.CONCLUSION Due to the high recurrence rate,SH is not an appropriate treatment option for patients with grade IV hemorrhoids.Open surgery may be a more suitable option for these patients. 展开更多
关键词 hemorrhoidS Stapled hemorrhoidopexy Procedure for prolapsed hemorrhoids Surgery RECURRENCE
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Hemorrhoidal elastic band ligation during routine colonoscopy:A comparative study between flexible video endoscopy and rigid proctoscopy
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作者 Alexandre Gomes Enzo Barrio +3 位作者 Guilherme Gomes JoséHenrique Carvalho Gandini de Souza Pérsio Campos Correia Pinto Ronaldo Antonio Borghesi 《World Journal of Gastrointestinal Endoscopy》 2025年第12期101-115,共15页
BACKGROUND Among patients referred for colonoscopy to evaluate bowel bleeding,many present with hemorrhoidal disease-associated bleeding and prolapse.AIM To compare endoscopic band ligation(EBL)with rigid proctoscope ... BACKGROUND Among patients referred for colonoscopy to evaluate bowel bleeding,many present with hemorrhoidal disease-associated bleeding and prolapse.AIM To compare endoscopic band ligation(EBL)with rigid proctoscope band ligation(RPBL)in patients referred for colonoscopy due to internal hemorrhoids.METHODS This retrospective cohort study included 171 patients with previous anal bleeding and hemorrhoidal prolapse complaints who underwent routine colonoscopy who were referred for band ligation treatment.Seventy-five patients underwent EBL,and 96 underwent RPBL.Control of bleeding,prolapse recurrence,pain,tenesmus,overall satisfaction,and cost were analyzed.A log-binomial regression model was used to analyze and compare binary outcomes between the ligation types,which allowed for the direct estimation of relative risks.RESULTS EBL achieved hemorrhoid symptom control in 92%of patients after a single session,compared with 63.5%for RPBL,which typically required three to four sessions(P<0.01).Short-term prolapse was significantly lower with EBL(13.3%)than with RPBL(55.2%,P<0.01),and long-term prolapse recurrence remained lower(8% vs 36.5%,P<0.01).Short-term bleeding was also reduced with EBL(4% vs 19%,P<0.01),while long-term bleeding control was comparable between groups(97.3% vs 92.7%).RPBL patients were more likely to report pain(relative risk=1.29;95%confidence interval:1.08-1.54;P<0.01).Overall satisfaction was markedly higher in the EBL group(86.7%“very satisfied”)than in the RPBL group(24%,P<0.01).CONCLUSION EBL demonstrated superior control of hemorrhoidal symptoms,lower prolapse recurrence,and better short-term bleeding outcomes compared with RPBL.Long-term bleeding control and tenesmus rates were comparable;however,numerical trends favored EBL.Despite a higher per-session cost,the reduced number of sessions made overall expenses similar.EBL appears to be a more effective,efficient,and well-tolerated minimally invasive option for treating symptomatic internal hemorrhoids. 展开更多
关键词 hemorrhoidS HEMORRHAGE PROLAPSE LIGATION COLONOSCOPY
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Laser hemorrhoidoplasty in focus:A modern alternative to conventional surgical techniques for symptomatic hemorrhoids
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作者 Alfadl Abdulfattah Fabricio Doin Paz de Oliveira 《World Journal of Surgical Procedures》 2025年第2期1-5,共5页
Hemorrhoidal disease is a prevalent anorectal condition causing significant morbidity,affecting approximately 4%of the general population with incidence increasing with age and sedentary lifestyle.While conventional e... Hemorrhoidal disease is a prevalent anorectal condition causing significant morbidity,affecting approximately 4%of the general population with incidence increasing with age and sedentary lifestyle.While conventional excisional hemorrhoidectomy techniques such as Milligan-Morgan and Ferguson remain standard for long-term efficacy,they are often associated with substantial postoperative pain and prolonged recovery.This narrative review evaluates the comparative clinical outcomes of laser hemorrhoidoplasty(LHP)versus conventional surgical interventions in the treatment of grade II and III symptomatic hemorrhoids.A comprehensive analysis of comparative studies,randomized controlled trials,and meta-analyses published between 2020 and 2025 was conducted,with primary outcomes including postoperative pain,recovery time,operative duration,complication rates,and recurrence.Key findings from studies by Maloku et al and Hassan et al.were analyzed to contextualize real-world LHP use.Across multiple high-quality studies,LHP was consistently associated with significantly lower postoperative pain scores,reduced analgesic requirements,and faster return to daily activities.Maloku et al demonstrated a shorter mean operative time(15.9 minutes)and reduced pain compared to open techniques(26.8 minutes;P<0.01).Hassan et al confirmed these benefits in a cohort of 40 patients treated under local anesthesia.Operative time was generally comparable or shorter,and vessel ligation was suggested as an adjunct to improve outcomes in select cases.Complication rates were low and similar between groups,with LHP demonstrating minimal risk for major complications such as anal stenosis or incontinence.However,recurrence rates were higher with LHP in some studies,particularly in grade III disease.LHP offers a minimally invasive,low-morbidity alternative to excisional hemorrhoidectomy for appropriately selected patients.Despite superior short-term recovery profiles,potential for higher recurrence underscores the importance of patient selection and long-term follow-up.The role of local anesthesia and adjunctive vessel ligation merits further prospective evaluation. 展开更多
关键词 Laser hemorrhoidoplasty hemorrhoidECTOMY Minimally invasive surgery hemorrhoidS Postoperative pain RECURRENCE Diode laser
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Clinical Study on the Combination Therapy of Diosmin Tablets and Mayinglong Musk Hemorrhoids Ointment for Patients with Acute Hemorrhoids
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作者 Quanchang Sun 《Journal of Clinical and Nursing Research》 2025年第6期286-292,共7页
Objective:To evaluate the clinical effect of combined therapy with Diosmin Tablets and Mayinglong Musk Hemorrhoids Ointment for patients with acute hemorrhoids.Methods:A total of 50 patients with acute hemorrhoids who... Objective:To evaluate the clinical effect of combined therapy with Diosmin Tablets and Mayinglong Musk Hemorrhoids Ointment for patients with acute hemorrhoids.Methods:A total of 50 patients with acute hemorrhoids who visited the hospital from January 2023 to January 2025 were selected as samples and randomly divided into two groups.Group A was treated with Diosmin Tablets combined with Mayinglong Musk Hemorrhoids Ointment,while Group B was treated with Mayinglong Musk Hemorrhoids Ointment only.The efficacy,wound recovery time,perianal pain score,hemorrhoid symptom score,and stress indicators were compared between the two groups.Results:The efficacy of Group A was higher than that of Group B(P<0.05).The postoperative perianal edema time and wound healing time in Group A were shorter than those in Group B,and the Visual Analog Scale(VAS)score was lower than that in Group B(P<0.05).The hemorrhoid symptom score in Group A was lower than that in Group B(P<0.05).The stress level in Group A was lower than that in Group B(P<0.05).Conclusion:The combination therapy of Diosmin Tablets and Mayinglong Musk Hemorrhoids Ointment for postoperative treatment of acute hemorrhoids can effectively relieve perianal pain,shorten the duration of hemorrhoids,and is highly feasible. 展开更多
关键词 Acute hemorrhoids Mayinglong musk hemorrhoids ointment Diosmin tablets EFFICACY
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TONEFACT:Can even advanced hemorrhoids be treated without surgery?A paradigm shift in the management of hemorrhoids
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作者 Pankaj Garg Inna Tulina +3 位作者 Dong-Lin Ren Kaushik Bhattacharya Vipul D Yagnik Garg Mahak 《World Journal of Gastrointestinal Surgery》 2025年第7期18-27,共10页
Hemorrhoids are one of the most common anorectal disorders.Early hemorrhoids are treated conservatively,but advanced hemorrhoids are usually treated with surgery.However,in the last decade,we have worked extensively i... Hemorrhoids are one of the most common anorectal disorders.Early hemorrhoids are treated conservatively,but advanced hemorrhoids are usually treated with surgery.However,in the last decade,we have worked extensively in the field of conservative management of hemorrhoids.From our experience,we could manage a large proportion of advanced hemorrhoids without surgery by a treatment concept(TONEFACT)with a high satisfaction rate.Evidence for the TONEFACT approach primarily comes from observational studies and a prospective,nonrandomized study of 85 patients.This has been shown to improve defecation time and reduce prolapse symptoms in early-stage hemorrhoids,leading to fewer surgical interventions.Although promising,these observations lack validation from more extensive randomized controlled trials to draw firm conclusions.In this opinion review,without using much data,we will discuss our viewpoint based on our experience as specified by the journal guidelines. 展开更多
关键词 hemorrhoidS FIBER Water intake NON-SURGICAL Conservative management
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Single-nucleus RNA sequencing and spatial transcriptomics reveal the mechanism by which Xiaozhiling injection treats internal hemorrhoids
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作者 Min-Hui Ke Shu-Yan Huang +5 位作者 Wei-Gan Lin Zhen-Guo Xu Xia-Xia Zheng Xian-Bao Liu You-Min Cheng Zuan-Fang Li 《World Journal of Gastrointestinal Surgery》 2025年第4期333-346,共14页
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
关键词 Internal hemorrhoids Xiaozhiling injection FIBROBLAST Marker gene Single-cell sequencing Spatial transcriptome sequencing
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Effects of Tongyangxiao lotion bidet therapy combined with Ziyu ointment on postpartum hemorrhoidal pain,oedema,anxiety,and depression
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作者 Xiao-Hui Wang Na Li +2 位作者 Xia Liu Xin Liu Chen-Song Shi 《World Journal of Psychiatry》 2025年第12期202-211,共10页
BACKGROUND Postpartum hemorrhoids are common complications in women after childbirth,with an incidence rate of 37.9%.Progesterone levels increase during pregnancy,which can lead to constipation.Abdominal pressure surg... BACKGROUND Postpartum hemorrhoids are common complications in women after childbirth,with an incidence rate of 37.9%.Progesterone levels increase during pregnancy,which can lead to constipation.Abdominal pressure surges sharply during delivery,which can block the venous return of the rectum and result in hemorrhoids,pain,and edema.Tongyangxiao lotion and Ziyu ointment,traditional Chinese medicinal preparations,have the efficacy of subduing swelling,relieving itching,and promoting healing;however,their combined application in treating postpartum hemorrhoids is less studied.AIM To investigate effects of Tongyangxiao lotion sitz bath therapy combined with Ziyu ointment on postpartum hemorrhoidal pain,edema,anxiety,and depression.METHODS A retrospective analysis was conducted at Hebei Hospital of Traditional Chinese Medicine on 268 patients with hemorrhoids(September 2023 to February 2025).They were divided according to treatment method into control(wet compress with magnesium sulfate+Ziyu ointment)and observation(Tongyangxiao lotion sitz bath therapy+Ziyu ointment)groups(n=134 in each group).Degree of pain,comfort level,compliance behavior with medical care,psychological state,therapeutic effect,hemorrhoid edema score,incidence of adverse reactions,and hemorrhoid diameter were compared.RESULTS No statistically significant difference was observed in the diameter of the hemorrhoids or edema between the two groups before treatment.Hemorrhoid diameter and degree of edema were significantly smaller in the observation group than those in the control group 14 days post treatment.No statistically significant difference was observed in the scores of the General Comfort Questionnaire(GCQ)dimensions and participants’compliance before treatment.All GCQ dimension scores were significantly higher in the observation group than those in the control group 7 and 14 days post treatment.The compliance rate was significantly higher in the observation group than that of the control group.No statistically significant difference was observed in the incidence of adverse reactions between the two groups(P>0.05).CONCLUSION Tongyangxiao lotion combined with Ziyu ointment can improve patients’surface edema,postpartum hemorrhoid pain,treatment adherence,and comfort,reducing negative emotions.This is relatively safe and worthy of clinical promotion. 展开更多
关键词 Postpartum hemorrhoids Tongyangxiao lotion Ziyu ointment Chinese medicine fumigation PAIN
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An's anorectal fumigation lotion for nuclear factor kappa-B pathway-targeted treatment of inflammatory mixed hemorrhoids
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作者 FENG Dayong AN Ayue +3 位作者 FENG Yuening WANG Chunhui BAI Zhiyong WANG Qian 《Journal of Traditional Chinese Medicine》 2025年第4期777-785,共9页
OBJECTIVE:To investigate the mechanism by which An's anorectal fumigation lotion(AAFL)treats inflammatory mixed hemorrhoids.METHODS:Eighty Sprague-Dawley rats,with an equal number of males and females,were randoml... OBJECTIVE:To investigate the mechanism by which An's anorectal fumigation lotion(AAFL)treats inflammatory mixed hemorrhoids.METHODS:Eighty Sprague-Dawley rats,with an equal number of males and females,were randomly assigned to the following four groups:control,model,AAFL,and positive groups.Following hemorrhoid induction,hemorrhoidal tissues were collected from the rats for analysis.Pathological alterations in these tissues were examined via hematoxylin-eosin staining.Immunohistochemistry was used to detect inflammatory markers.The ultrastructural pathological changes in these tissues were observed by transmission electron microscopy.Reverse transcription-polymerase chain reaction and Western blotting were used to analyze the gene and protein expression of nuclear factor kappa-B(NF-κB)p65,inhibitor of kappa-B(IκB),inhibitor of NF-κB kinase(IκK-β),interleukin-1 beta(IL-1β),interleukin-6(IL-6),and tumor necrosis factor-alpha(TNF-α).RESULTS:Compared with the control group,the rats in each treatment group showed general improvements in hemorrhoidal tissue pathology.The AAFL group showed increased IκB expression and decreased IL-1β,IL-6,TNF-α,NF-κB,p65,and IκK-βexpressions.CONCLUSION:AAFL can decrease the production of inflammatory markers by targeting the NF-κB pathway,resulting in improved pathological conditions in mixed hemorrhoids.Our findings will aid in the treatment of mixed hemorrhoids. 展开更多
关键词 hemorrhoidS NF-kapa B inflammatory factors An’s anorectal fumigation lotion
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Remimazolam reduces State-Trait Anxiety Inventory-State Scale scores in hemorrhoid surgery with spinal-epidural anesthesia:A randomized trial
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作者 Tao Hu Qian Huang +2 位作者 Lai Wei Shi Zhong Jing Wang 《World Journal of Gastrointestinal Surgery》 2025年第9期343-354,共12页
BACKGROUND In the field of anesthesia for procedure for prolapse and hemorrhoids(PPH)surgery,combined spinal-epidural(CSE)anesthesia has been a common approach.However,exploring new combinations to optimize patient ou... BACKGROUND In the field of anesthesia for procedure for prolapse and hemorrhoids(PPH)surgery,combined spinal-epidural(CSE)anesthesia has been a common approach.However,exploring new combinations to optimize patient outcomes remains crucial.Remimazolam,a short-acting benzodiazepine,shows potential for improving sedation and reducing patient anxiety.The effects of combining remimazolam with CSE anesthesia,compared to traditional CSE anesthesia alone,on patient anxiety,sedation depth,and hemodynamics during PPH surgery have not been fully elucidated.AIM To compare remimazolam-CSE vs CSE alone on State-Trait Anxiety Inventory-State scale(STAI-S)scores,sedation,and hemodynamics in PPH surgery.METHODS This study is a single-center,prospective,randomized controlled trial.Between November 23,2022,and August 6,2024,60 eligible patients were randomly assigned to the CSE anesthesia group or the remimazolam-combined CSE anesthesia group(30 patients each).STAI-S scores,Ramsay sedation scores,and hemodynamic parameters(systolic blood pressure,diastolic blood pressure,heart rate)were measured at multiple time points.Two-way mixed-effects ANOVA and posthoc analyses were performed.RESULTS The Combined group demonstrated significantly lower STAI-S scores before leaving the operating room[mean:28.80 vs 54.03,mean difference(95%CI):25.23(21.24-29.23),P<0.001]and 24 hours post-operation[mean:45.07 vs 54.53,mean difference(95%CI):9.47(6.29-12.64),P<0.001]than the CSE group.Moreover,the Combined group achieved a deeper sedation level during intraoperative maintenance[median:5.00(IQR:5.00-5.00)vs 2.00(IQR:2.00-2.00);median difference(95%CI):3.00(3.00-3.00),P<0.001].Regarding hemodynamics,a significant intergroup difference in systolic blood pressure was observed at the start of the surgery[mean:128.8 vs 114.7 for the Combined and CSE groups,mean difference(95%CI):14.17(0.77-27.57),adjusted P=0.033].CONCLUSION Remimazolam-combined anesthesia outperformed CSE anesthesia in reducing STAI-S scores,enhancing intraoperative sedation,and stabilizing systolic blood pressure at a critical stage,indicating its superiority in perioperative management. 展开更多
关键词 Procedure for prolapse and hemorrhoids surgery Combined spinal-epidural anesthesia Remimazolam-based combined anesthesia State-Trait Anxiety Inventory-State Scale scores Sedation depth Hemodynamics
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Optimizing circumferential prolapsed hemorrhoid surgery:Transverse incision with longitudinal ligation procedure delivers superior radicality compared to Milligan-Morgan technique
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作者 Xin-Bo Song Yan-Zhi Wang +7 位作者 Yan-Mei Wang Hong Sun Jia-Nan Li Huang-Fu Ma Xin Li Ting-Ting Sui Rui-Han Liu Li-Xia Lai 《World Journal of Gastroenterology》 2025年第39期153-160,共8页
BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with signifi... BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with significant post-operative pain,edema,and delayed healing in severe CPH cases.To address these limitations,our research team innovatively proposed the transverse incision with longitudinal ligation procedure(TILL).This novel technique utilizes targeted transverse incisions and longitudinal pedicle ligation to optimize complete resection while preserving anal anatomy and function.METHODS A total of 180 patients were retrospectively reviewed in China.The patients were divided into two groups of 90 based on the surgical methods.The treatment group underwent the TILL procedure,while the control group underwent MMH.The main observation index was the evaluation of clinical efficacy after wound healing.Secondary outcomes included the recurrence rate and wound healing time.Safety measurements were also evaluated.RESULTS The TILL group showed a significant difference compared to the MMH group(P=0.022),indicating better overall treatment effects.The time for wound healing in the TILL group was shorter than that in the MMH group(P=0.001).Compared to those who underwent MMH,those who underwent TILL experienced significantly reduced postoperative pain,with lower average scores for anal edema and anal stenosis(both P<0.05).CONCLUSION TILL demonstrates superior efficacy to MMH for advanced CPH,reducing recovery times and postoperative pain,edema,and stenosis while preserving anal function. 展开更多
关键词 Circumferential prolapsed hemorrhoid Milligan-Morgan hemorrhoidectomy Transverse incision with longitudinal ligation procedure Efficacy Anal function
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Postoperative pain of mixed hemorrhoid treated by embedding needles in rbái(二白 EX-UE 2) 被引量:11
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作者 白岩 陈苏宁 +1 位作者 陈丽荣 王波 《World Journal of Acupuncture-Moxibustion》 CSCD 2015年第1期59-61,共3页
Objective To explore the effectiveness of treating postoperative pain of mixed hemorrhoid by embedding needles in Erbai (二白EX-UE 2) and find possible ways for relieving postoperative pain of mixed hemorrhoids. Met... Objective To explore the effectiveness of treating postoperative pain of mixed hemorrhoid by embedding needles in Erbai (二白EX-UE 2) and find possible ways for relieving postoperative pain of mixed hemorrhoids. Methods press needle (SEIRIN pyonexes) were embedded in EX-UE 2 of patients with postoperative pain of mixed hemorrhoid, once a day and totally 7 treatments. Visual analogue scale (VAS) values were adopted for evaluation. Results Complete remission of clinical pain was observed in 34 cases, accounting for 50.00%; significantly effective in 19 cases, accounting for 27.94%; effective in 13 cases, accounting for 19.12%; and ineffective in 2 cases, accounting for 2.94%; the total effective rate was 97.06%. Conclusion The therapy of treating postoperative pain of mixed hemorrhoid by embedding press needle in EX-UE2 is effectively satisfactory. 展开更多
关键词 Erbai (二白EX-UE 2) postoperative pain of mixed hemorrhoids press needle acupoint needle-embedding
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Effects of electroacupuncture at Chéngshān (承山 BL 57) on postoperative pain of mixed hemorrhoids 被引量:3
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作者 孙平良 杨伟 张磊昌 《World Journal of Acupuncture-Moxibustion》 2011年第4期15-18,43,共5页
ABSTRACT Objective To discuss the effect of electroacupuncture at Chengshan (承山 BL 57) on postoperative pain of mixed hemorrhoids. Methods One hundred and twenty cases with postoperative pain of mixed hemorrhoids ... ABSTRACT Objective To discuss the effect of electroacupuncture at Chengshan (承山 BL 57) on postoperative pain of mixed hemorrhoids. Methods One hundred and twenty cases with postoperative pain of mixed hemorrhoids were divided into an electroacupuncture group (60 cases) and a medication group (60 cases) randomly. In electroacupuncture group disperse-dense wave in frequency of 2 Hz/100 Hz was adopted at Chengshan (承山 BL 57), the first treatment was given within 30 min after the operation, from the second day on electroacupuncture treatment was applied once a day and each time after hip bath in the morning. While in medication group 2 tablets of Naproxen Sunstained Release Capsule were administered orally within 30 min after operation, later on 2 tablets were taken before dressing change in the day. After 4 times of treatment, evaluate the changed condition of Visual Analogue Scale (VAS) at 5 h, 24 h, 48 h and 72 b after operation. Results In electroacupuncture group all tested pain scores at 5 h, 24 h, 48 h and 72 h after operation (6.78±2.12, 5.56±1.87, 4.34±2.23 and 3.15±2.11) were lower than those in the medication group (7.56±2.01, 6.23±1.15, 5.57±2.21 and 4.34±2.12), and the difference was statistically significant (all P〈0.05). Conclusion Electroacupuncture at Chengshan (承山 BL 57) can reduce the postoperative oain of mixed hemorrhoids. 展开更多
关键词 ELECTROACUPUNCTURE Point BL 57 (Chengshan) Mixed hemorrhoid Post Operative Pain
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透明帽辅助内镜下泡沫硬化术治疗内痔的临床效果分析
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作者 许开武 陈鸿西 +1 位作者 侯福涛 喻志革 《首都食品与医药》 2026年第3期49-52,共4页
目的探究透明帽辅助内镜下泡沫硬化术对内痔的治疗效果。方法提取本院收治的Ⅱ-Ⅲ度内痔患者临床资料进行研究(2024年1月-2025年6月)。共纳入患者80例,将住院号录入计算机,随机分为对照组(采用内镜下套扎术治疗)和观察组(采用透明帽辅... 目的探究透明帽辅助内镜下泡沫硬化术对内痔的治疗效果。方法提取本院收治的Ⅱ-Ⅲ度内痔患者临床资料进行研究(2024年1月-2025年6月)。共纳入患者80例,将住院号录入计算机,随机分为对照组(采用内镜下套扎术治疗)和观察组(采用透明帽辅助内镜下泡沫硬化术治疗),对比组间临床效果。结果干预3d、7d时,观察组疼痛评分较低(P<0.05);观察组创面水肿消失时间、创面愈合时间、住院时间较短(P<0.05);观察组干预7d时,排便情况各维度评分较低(P<0.05);组间并发症发生率无显著差异(P>0.05)。结论对内痔手术患者实施透明帽辅助内镜下泡沫硬化术治疗成效显著,有助于促进创面愈合,减轻疼痛。 展开更多
关键词 内痔 透明帽辅助 内镜 泡沫硬化 创面愈合 疼痛
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RPH联合外剥内扎术治疗混合痔的临床效果
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作者 樊海 韩翼 龙启军 《中国医学创新》 2026年第1期140-143,共4页
目的:探讨混合痔患者联合应用自动痔套扎术(RPH)与外剥内扎术治疗的效果。方法:选取混合痔患者100例,均来源于安顺市人民医院(2020年3月—2023年6月),并根据随机数字表法分为观察组(n=50,给予RPH+外剥内扎术治疗)和对照组(n=50,给予外... 目的:探讨混合痔患者联合应用自动痔套扎术(RPH)与外剥内扎术治疗的效果。方法:选取混合痔患者100例,均来源于安顺市人民医院(2020年3月—2023年6月),并根据随机数字表法分为观察组(n=50,给予RPH+外剥内扎术治疗)和对照组(n=50,给予外剥内扎术治疗)。比较两组手术效果、创面愈合时间、肛管血流动力学指标及肛门功能。结果:观察组术中出血量少于对照组,创面愈合时间早于对照组,手术耗时、住院时间短于对照组(P<0.05)。术后1个月,观察组肛管最大峰值流速、最小峰值流速低于对照组(P<0.05)。术后1个月,观察组Wexner肛门失禁量表总分低于对照组(P<0.05)。结论:RPH联合外剥内扎术治疗混合痔患者的效果良好,可缩短恢复时间,改善肛管血流动力学与肛门功能。 展开更多
关键词 自动痔套扎术 外剥内扎术 混合痔
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乳没黄及方塌渍联合TDP照射治疗湿热夹瘀型混合痔术后肛缘水肿临床研究
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作者 许莹 范艺缤 文圆 《山东中医杂志》 2026年第1期36-41,共6页
目的:分析乳没黄及方塌渍联合特定电磁波谱(TDP)照射治疗湿热夹瘀型混合痔术后肛缘水肿临床疗效及对患者肛门功能与促血管新生因子的影响。方法:选取2023年6月至2024年6月在本院就诊的湿热夹瘀型混合痔患者140例,采用随机数字表法分为... 目的:分析乳没黄及方塌渍联合特定电磁波谱(TDP)照射治疗湿热夹瘀型混合痔术后肛缘水肿临床疗效及对患者肛门功能与促血管新生因子的影响。方法:选取2023年6月至2024年6月在本院就诊的湿热夹瘀型混合痔患者140例,采用随机数字表法分为对照组和观察组各70例。对照组术后使用TDP照射结合温水坐浴治疗,观察组术后使用乳没黄及方塌渍联合TDP照射治疗。比较两组的临床疗效、中医证候积分、肛门功能与促血管新生因子、炎症因子水平以及不良反应。结果:治疗后,观察组的总有效率高于对照组(P<0.05)。治疗后,两组患者的中医证候积分、肛管最长收缩时间(ALCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)及C反应蛋白(CRP)水平均低于治疗前,而肛管收缩压(ASP)、肛管舒张压(ADP)、肛管静息压(ARP)、血管内皮生长因子(VEGF)、成纤维细胞生长因子-1(FGF-1)、纤维连接蛋白(FN)、转化生长因子-β1(TGF-β1)水平均高于治疗前(P<0.05)。且观察组的中医证候积分、ALCT、TNF-α、IL-1β、IL-6及CRP水平低于对照组,而ASP、ADP、ARP、VEGF、FGF-1、FN、TGF-β1水平高于对照组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论:乳没黄及方塌渍联合TDP照射治疗湿热夹瘀型混合痔能够改善患者促血管新生因子与炎症因子的水平,改善患者肛缘水肿等临床症状,提高患者的肛门功能,促进患者康复。 展开更多
关键词 乳没黄及方 塌渍 特定电磁波谱照射 湿热夹瘀型混合痔 肛缘水肿 肛门功能 促血管新生因子
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痔点刮痧疗法对混合痔术后排便困难的预防效果
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作者 杨正祥 李东华 《临床医学研究与实践》 2026年第2期113-116,共4页
目的观察痔点刮痧疗法对混合痔术后排便异常、尿潴留等并发症的影响。方法选取2023年8月至2024年3月于剑阁县中医医院行外剥内扎手术的94例混合痔患者为研究对象,以随机数字表法将其分为观察组和对照组,每组47例。两组患者均由同一医疗... 目的观察痔点刮痧疗法对混合痔术后排便异常、尿潴留等并发症的影响。方法选取2023年8月至2024年3月于剑阁县中医医院行外剥内扎手术的94例混合痔患者为研究对象,以随机数字表法将其分为观察组和对照组,每组47例。两组患者均由同一医疗组完成外剥内扎术,对照组采用混合痔术后常规干预,观察组在对照组基础上增加痔点刮痧治疗。比较两组患者术后膀胱残余尿量、术后7 d内导尿率、肛肠动力学指标及便秘发生情况。结果术后第1、3、5天,观察组的膀胱残余尿量低于对照组(P<0.05);术后第7天,两组患者的膀胱残余尿量比较,差异无统计学意义(P>0.05)。观察组术后7 d内导尿率低于对照组(P<0.05)。术后第7天,观察组的肛管静息压低于对照组,肛管最大收缩压高于对照组(P<0.05)。观察组术后7 d内便秘发生率低于对照组(P<0.05)。结论痔点刮痧疗法可减少混合痔术后患者膀胱残余尿量,调节肛肠动力学指标,改善术后排便异常及尿潴留症状,优化患者手术体验。 展开更多
关键词 痔点刮痧疗法 混合痔 便秘 尿潴留 肛肠动力学
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泡沫敷料在痔术后肛周创面愈合中的临床观察
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作者 吕警军 王家顿 《中外女性健康研究》 2026年第1期46-50,共5页
目的:观察泡沫敷料在痔术后肛周创面愈合中的治疗效果。方法:将本科收治的160例混合痔行改良Milligan-Morgan术患者随机分成试验组和对照组,各80例;试验组术后采用泡沫敷料换药治疗,对照组按凡士林纱条方法换药。观察两组患者创面渗液... 目的:观察泡沫敷料在痔术后肛周创面愈合中的治疗效果。方法:将本科收治的160例混合痔行改良Milligan-Morgan术患者随机分成试验组和对照组,各80例;试验组术后采用泡沫敷料换药治疗,对照组按凡士林纱条方法换药。观察两组患者创面渗液量、创面水肿、肛门疼痛、创面愈合时间、肛周皮肤浸渍、创面愈合后瘢痕等,进行疗效评定。结果:试验组术后3d、7d、10d创面渗液量、创面水肿及疼痛程度评分减少,创面水肿消退时间、创面愈合时间明显短于对照组,组间统计差异显著,P<0.05;试验组在伤口愈合时间,患者疼痛,瘢痕形成等方面明显优于对照组(P<0.05)。结论:泡沫敷料用于混合痔术后肛周创面换药,可促进创面渗液量减少、创面水肿消退,促进伤口愈合,伤口疼痛减少,减少并发症形成。 展开更多
关键词 混合痔 术后 创面恢复 泡沫敷料
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