Grade of prolapse and symptoms of haemorrhoids are poorly correlated:: result of a classification algorithm in 270 patients
Grade of prolapse and symptoms of haemorrhoids are poorly correlated:: result of a classification algorithm in 270 patients
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DOI：
10.1111/j.1463-1318.2008.01498.x
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发表时间：
2008-09-01
影响因子：
3.4
通讯作者：
Nystrom, P. -O.
中科院分区：
文献类型：
--
作者：
Gerjy, R.;Lindhoff-Larson, A.;Nystrom, P. -O.
目的痔脱垂是手术适应证。通常认为解剖结构恶化与症状增加之间存在相关性。我们开发了一个分类算法的脱垂和外部组件，并评估其相关性的症状之前和之后surgery.Method的研究人群，包括180名患者在一个多中心的随机试验加一个验证集，包括90名患者由我们操作的痔疮。该分类使用三个项目：（i）患者自我报告需要手动复位的脱垂;（ii）当患者否定手动复位时，外科医生评估脱垂;（iii）外科医生评估外部组件。按频率对患者自我报告进行评分（从不，0分;每月1分;每周2分和每日3分）。该算法产生了三个等级：1，无脱垂; 2，自发减少脱垂和3，脱垂需要手动复位。结果两组患者术前、术后的解剖学分级无差异。术前，69%有3级脱垂。术后，89%被分类为1A或B级。2级和3级的症状负荷是相似的，平均6.5分术前和1.8分postoperatives.Conclusion这种解剖学分类，严格的标准的基础上，可靠分期痔脱垂。没有与任何程度的脱垂（有或没有外部组件）相关的独特术前症状特征。恢复肛门解剖缓解症状。该分类还定义了痔疮的复发。
Purpose Haemorrhoid prolapse is an indication for surgery. A correlation between worsening anatomy and increasing symptoms is commonly assumed. We developed a classification algorithm of prolapse and external component, and evaluated its correlation to symptoms before and after surgery.Method A study population comprising 180 patients operated for haemorrhoids in a multicentre randomized trial plus a validation set comprising 90 patients operated by us. The classification used three items: (i) patient self-report of prolapse requiring manual reposition; (ii) surgeon assessment of prolapse when patient negated manual reposition; (iii) surgeon assessment of external component. Patient self-reported were rated by frequency (never, 0 points; monthly, 1 point; weekly, 2 points and daily, 3 points). The algorithm yielded three grades: 1, no prolapse; 2, spontaneously reducing prolapse and 3, prolapse needing manual repositioning. The degree of external component was affixed as A, none; B, one or few tags and C, circumferential.Results Anatomical grades did not differ between the two sets of patients before or after surgery. Preoperatively, 69% had grade 3 prolapse. Postoperatively, 89% were classified as grades 1A or B. The symptom load was similar for grades 2 and 3; mean 6.5 points preoperatively and 1.8 points postoperatively.Conclusion This anatomical classification, based on strict criteria, reliably staged the haemorrhoid prolapse. There was no unique preoperative symptom profile associated with any degree of prolapse with or without an external component. Restored anal anatomy relieved symptoms. The classification also defined recurrence of haemorrhoids.