Rubber band ligation for hemorrhoidal disease can be safely performed in select HIV-positive patients
Rubber band ligation for hemorrhoidal disease can be safely performed in select HIV-positive patients
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DOI：
10.1007/bf02234625
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发表时间：
2001-08-01
影响因子：
3.9
通讯作者：
Fleshner, PR
中科院分区：
文献类型：
--
作者：
Moore, BA;Fleshner, PR
目得：许多外科医生已经放弃使用橡皮圈结扎治疗感染人类免疫缺陷病毒的患者的痔疮，因为他们认为这种手术可能导致灾难性的后果。本研究旨在评价橡皮圈结扎在其他健康的人类免疫缺陷病毒阳性患者中的安全性和有效性。方法：采用正交设计法对1993年4月至2000年5月期间因有症状痔疮接受橡皮圈结扎术的健康人类免疫缺陷病毒阳性患者进行了回顾性图表审查。结果：研究组包括11名患者。所有患者均为男性，中位年龄为48岁（范围：32-64岁）。平均辅助T细胞计数为450（范围，200- 1，000）个细胞/穆尔。每例患者平均进行2次（范围，1-4次）橡皮筋结扎。随访时间中位数为7个月（范围：1-28）。任何研究组患者均无死亡或并发症。8名患者（73%）的结果非常好，症状完全缓解。两名患者（18%）最初有改善，但随后因复发症状而接受了痔切除术。只有一名患者（9%）没有从橡皮圈结扎中受益，并接受了痔切除术。结论：这些数据表明，无症状的人类免疫缺陷病毒阳性患者可以安全有效地治疗有症状的痔疮橡皮圈结扎。
PURPOSE: Many surgeons have abandoned the use of rubber band ligation for the treatment of hemorrhoids in patients infected with human immunodeficiency virus because of the belief that this procedure could lead to disastrous outcomes. This study was designed to evaluate the safety and efficacy of rubber band ligation in otherwise healthy human immunodeficiency virus-positive patients. METHODS: A retrospective chart review of healthy human immunodeficiency virus-positive patients who underwent rubber band ligation for symptomatic hemorrhoids between April 1993 and May 2000 was conducted. RESULTS: The study group comprised 11 patients. All patients were male, with a median age of 48 (range, 32-64) years. Mean T-cell helper count was 450 (range, 200-1,000) cells/mul. A median of 2 (range, 1-4) rubber band Ligations were performed per patient. The median length of follow-tip was seven (range, 1-28) months. There were no deaths or complications in any study group patient. Eight patients (73 percent) had excellent results, with complete resolution of symptoms. Two patients (18 percent) had initial improvement but subsequently had hemorrhoidectomy because of recurrent symptoms. Only one patient (9 percent) had no benefit from rubber band ligation and underwent hemorrhoidectomy. CONCLUSION: These data suggest that asymptomatic human immunodeficiency virus-positive patients can be treated safely and effectively with rubber band ligation for symptomatic hemorrhoids.