摘要
痔病是临床常见肛肠疾病之一,其高发病率与高复发率给医患双方均造成压力.痔病评估是诊断痔病及选择治疗方式的必要前提,怎样客观评估痔病并选择适宜治疗技术是临床医师关注的焦点问题.近年来,国内外学者聚焦痔病评估提出多种痔病评估分类法.本文回顾了痔病评估分类法研究进展,主要包括以脱垂为主要评估指标的评估分类法:Goligher分类法、印度痔病新分类法、单痔分类法、脱垂痔评估流程;以出血为主要评估指标的评估分类法:日本内痔结肠镜分类、PNR-bleeding分类;综合评估分类法:Lunniss内痔分类法、解剖/临床-治疗分类、BPRST分类法、BPECT分期法、内痔与混合痔"四因素"评估方案,旨在分析其评估价值,探讨其必要因素、使用原则及评估指标组成,并针对其局限性提出优化策略,同时推测未来可能的发展方向,以期为痔病评估分类法发展及痔病临床诊疗提供参考.
Abstract
As a common anorectal disease,the high incidence and recurrence of hemorrhoidal disease impose pressure on both doctors and patients.Hemorrhoidal disease assessment is a necessary prerequisite for diagnosis and selection of appropriate treatment options.Objective assessment of hemorrhoidal disease and selection of an appropriate treatment are strong concerns of clinicians,and many hemorrhoidal disease classification methods have been developed recently.We reviewed these recently emerged hemorrhoidal disease classification methods,which mainly include prolapse-dominated classification methodologies(Goligher classification,Indian new classification algorithm of haemorrmoids,single pile classification,algorithm for grading prolapsing haemorrhoids),bleeding-dominated classification methodologies(Japanese endoscopic classification of internal hemorrhoids,PNR-bleeding classification),and comprehensive classification methodologies[Lunniss's classification of internal haemorrhoids,anatomical/clinical-therapeutic classification,BPRST classification,BPECT classification,four-factors(PBCE)hemorrhoids classification],then analyzed evaluation values,essential factors,principles of use and components of assessment indicators of the methods.Afterwards,we put forward optimization strategies targeting their limitations and predicted their possible future development directions.All these will provide a reference for the development regarding the assessment and classification of hemorrhoids and clinical diagnosis and management of hemorrhoids.
基金项目
重庆市璧山区科技局社会民生领域科技计划(2022)(BSKJ0089)
维普
万方数据