关键词: 直肠上动脉栓塞术； 内痔； 临床疗效； 疼痛程度

Abstract: Objective To investigate the effect of upper rectal artery (SRA) embolization on clinical treatment,intraoperative blood loss and pain in patients with stage Ⅱ to Ⅲ hemorrhoids.Methods A total of 84 patients diagnosed with stage Ⅱ to Ⅲ hemorrhoids in our hospital from January 2021 to January 2022 were selected.According to different surgical interventions,PPH group and SRA group were established,with 42 cases in each group.The PPH group was treated with hemorrhoid mucosa ring resection and nailing operation,and the SRA group was treated with upper rectal artery embolization.The clinical efficacy,perioperative indicators,anal symptoms,postoperative pain,anorectal dynamics indicators,and incidence of postoperative complications were compared between the two groups.All patients received a 6-month follow-up survey after the operation,and the recurrence of hemorrhoids during the follow-up period was collected,and Kaplan-Meier curve was used for comparative analysis.Results The total effective rates of SRA group and PPH group at 12 months after operation were 92.86% and 76.19%,operation time was (17.23±4.26) min and (43.16±9.37) min,hospital stay was (5.52±1.89)d and (8.25±2.67)d,wound healing time was (7.36±2.23)d and (17.83±4.04)d, the intraoperative blood loss was (10.03±2.38) ml and (16.22±3.11) ml,and the operative cost were (14327.36±892.23) yuan and (2762.83±524.04) yuan, postoperative anal incontinence was (0.45±0.02) points and (0.60±0.09) points,anal pain score was (3.04±0.14) points and (5.15±1.68) points,anal bleeding scores was (0.43±0.08) points and (0.61±0.19) points,symptom scores of anal border edema was (0.29±0.09)points and (0.52±0.16)points,respectively.The difference between the two groups was statistically significant (all P<0.05).Postoperative rectal resting pressure (RRP) [(2.41±0.35) kPa vs. (2.95±0.29) kPa] and anal canal resting pressure (ARP) [(13.14±1.51) kPa vs. (14.67±1.59) kPa] levels between the SRA group and PPH group were statistically significant at 12 months after surgery（P＜0.05).Postoperative maximum systolic blood pressure (AMCP) of anal canal in SRA group [(14.22±0.28) kPa] was significantly higher than that in PPH group [(13.35±0.23) kPa] ( P<0.05).The total incidence of complications 12 months after operation in SRA group was significantly lower than that in PPH group (4.76% vs. 21.43%) (P＜0.05).After surgery,both groups were followed up for 12 months.In SRA group,13 cases (30.95%) recurred internal hemorrhoids.In the PPH group,10 patients (23.81%) had internal hemorrhoid recurrence,and there was no significant difference between the two groups (P＞0.05).Conclusion SRA can effectively improve clinical efficacy in the treatment of stage Ⅱ to Ⅲ hemorrhoids patients,and has positive significance in promoting rapid recovery of patients and improving adverse symptoms such as pain degree.

Key words: upper rectal artery embolization; hemorrhoids; clinical effect; pain degree