中国全科医学 ›› 2024, Vol. 27 ›› Issue (20): 2545-2550.DOI: 10.12114/j.issn.1007-9572.2022.0704

• 综述与专论 • 上一篇    下一篇

痔病评估分类法研究进展及评估价值分析

倪嘉淳1,2, 蔡增进2, 侯长城2, 江琼1, 康健3, 杨向东4, 樊文彬1,*()   

  1. 1.400016 重庆市,重庆医科大学中医药学院
    2.402160 重庆市,重庆医科大学附属永川中医院肛肠科
    3.610075 四川省成都市,成都中医药大学附属医院肛肠科
    4.610015 四川省成都市,成都肛肠专科医院
  • 收稿日期:2022-09-22 修回日期:2022-11-10 出版日期:2024-07-15 发布日期:2024-04-08
  • 通讯作者: 樊文彬

  • 作者贡献:

    倪嘉淳负责文献收集、整理,撰写论文;倪嘉淳、蔡增进、江琼、樊文彬负责文章构思;侯长城、康健、杨向东、樊文彬负责论文的修订;樊文彬负责文章的质量控制及审校,对文章整体负责,监督管理。

  • 基金资助:
    重庆市璧山区科技局2022年社会民生领域科技计划项目(BSKJ0089)

Hemorrhoidal Disease Classification Methods: Recent Advances and Value Analysis

NI Jiachun1,2, CAI Zengjin2, HOU Changcheng2, JIANG Qiong1, KANG Jian3, YANG Xiangdong4, FAN Wenbin1,*()   

  1. 1. College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing 400016, China
    2. Department of Proctology, Yongchuan Hospital of Traditional Chinese Medicine, Chongqing Medical University, Chongqing 402160, China
    3. Department of Proctology, Hospital of Chengdu University of TCM, Chengdu 610075, China
    4. Chengdu Anorectal Hospital, Chengdu 610015, China
  • Received:2022-09-22 Revised:2022-11-10 Published:2024-07-15 Online:2024-04-08
  • Contact: FAN Wenbin

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。

关键词: 痔, 症状评估, 分类法, 外科手术, 综述

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.

Key words: Hemorrhoid, Symptom assessment, Classification, Surgical procedures, operative, Review