2025 年第 8 期 第 20 卷

不同剂量聚桂醇硬化剂治疗出血性内痔的临床观察

Clinical observation of different doses of lauromacrogol sclerotherapy for hemorrhagic internal hemorrhoids

作者：万雨欣1高山2

英文作者：Wan Yuxin1 Gao Shan2

单位：1武汉科技大学医学部医学院，武汉430065；2湖北文理学院附属医院襄阳市中心医院消化内科，襄阳441021

英文单位：1School of Medicine Medical Department Wuhan University of Science and Technology Wuhan 430065 China; 2Department of Gastroenterology Xiangyang Central Hospital Affiliated to Hubei University of Arts and Science Hubei Province Xiangyang 441021 China

关键词：出血性内痔；聚桂醇；硬化疗法；药物剂量

英文关键词：Hemorrhagicinternalhemorrhoids;Lauromacrogol;Sclerotherapy；Drugdosage

• 摘要：

• 目的 探讨内镜下单点注射小剂量（0.2～＜0.5 ml）与标准剂量（0.5～1.5 ml）聚桂醇硬化剂治疗出血性内痔的临床疗效、安全性及患者满意度，以期为临床实践提供科学依据与参考。方法 选取2021年1月至2024年11月于湖北省襄阳市中心医院接受聚桂醇硬化治疗的出血性内痔患者137例，根据单点注射剂量分为标准剂量组（99例）和小剂量组（38例）。对比2组患者术中指标、术后并发症发生情况、临床疗效、生活质量及患者满意度方面指标。结果  小剂量组操作时间、单点注射平均剂量、注射总量均短于/少于标准剂量组［（23±3）min比（25±4）min、（0.46±0.08）ml比（0.95±0.33）ml、（1.8±0.6）ml比（4.4±1.9）ml］，差异均有统计学意义（均P＜0.05）。小剂量组术后脏污和肛门坠胀发生率显著低于标准剂量组（均P＜0.05）。术后至少8周的随访发现，标准剂量组出血与脱出发生率均高于小剂量组，差异均有统计学意义（均P＜0.05）。标准剂量组总有效率与小剂量组比较［99.0%（98/99）比100.0%（38/38）］,差异无统计学意义（P=0.303）。小剂量组在行动能力、自我照顾能力和日常活动能力方面表现相对标准剂量组更优（均P＜0.05）。小剂量组患者满意程度较标准剂量组更高，差异有统计学意义（P=0.02）。结论  内镜下单点注射小剂量聚桂醇治疗出血性内痔与注射标准剂量聚桂醇效果相当，且患者术后并发症更少、生活质量更好、满意度更高。

• Objective To investigate the differences of intraoperative related indicators, clinical efficacy, safety, postoperative quality of life and patient satisfaction between low-dose (0.2-<0.5 ml) and standard-dose (0.5-1.5 ml) lauromacrogol sclerotherapy in the treatment of hemorrhagic internal hemorrhoids, in order to provide scientific basis and reference for clinical practice. Methods A total of 137 patients with hemorrhagic internal hemorrhoids who received lauromacrogol sclerotherapy in Xiangyang Central Hospital, Hubei Province from January 2021 to November 2024 were selected. According to the single injection dose, they were divided into standard-dose group (99 cases) and low-dose group (38 cases). The intraoperative indicators, postoperative complications, clinical efficacy, quality of life and patient satisfaction were compared between the two groups. Results The operation time, average dose of single injection point and total injection volume in the low-dose group were shorter/less than those in the standard-dose group ［(23±3)min vs (25±4)min, (0.46±0.08)ml vs (0.95±0.33)ml, (1.8±0.6)ml vs (4.4±1.9)ml］(all P＜0.05). The incidences of postoperative dirt and anal distension in the low-dose group were significantly lower than those in the standard-dose group (both P＜0.05). At least 8 weeks of follow-up, the incidences of bleeding and prolapse in the standard-dose group were higher than those in the low-dose group (both P＜0.05). There was no significant difference in the total effective rate between the standard-dose group and the low-dose group ［99.0%(98/99) vs 100.0%(38/38)］(P=0.303). The low-dose group performed better than the standard-dose group in mobility, self-care ability, and daily activities (all P＜0.05). Patients in the low-dose group were more satisfied than those in the standard-dose group (P=0.02). Conclusion For patients with hemorrhagic internal hemorrhoids, endoscopic single-point injection of low-dose and standard-dose lauromacrogol has the same effect, and has fewer postoperative complications, better quality of life, and higher patient satisfaction.