内镜下芍倍注射术与胶圈套扎术治疗Ⅱ度内痔的临床疗效分析

Clinical efficacy analysis of endoscopic Shaobei injection and rubber band ligation in the treatment of gradeⅡinternal hemorrhoids

目的 通过对比观察内镜下芍倍注射术与胶圈套扎术治疗Ⅱ度内痔的临床疗效及安全性,为临床上Ⅱ度内痔患者的治疗方案提供建议。方法 回顾性收集2019年12月至2023年3月于中山大学附属第六医院内镜外科行内镜下治疗的96例Ⅱ度内痔患者的临床资料,按照治疗方式的不同,分为芍倍注射组(n=48)及胶圈套扎组(n=48),比较两组术后不良事件(术后肛门疼痛、肛门坠胀及肛门水肿)、围手术期并发症、治疗费用、生活质量评价、综合疗效及治疗满意度。结果 芍倍注射组术后第1天及术后第7天的肛门疼痛VAS评分均低于胶圈套扎组,术后第1天肛门坠胀的发生率较胶圈套扎组低(P <0.001)。术后第1周内,芍倍注射组发生出血的发生率更低(P <0.05),两组间尿潴留及发热发生率比较差异均无统计学意义(P> 0.05)。芍倍注射组治疗费用少于胶圈套扎组,差异有统计学意义(P <0.001)。术后3个月胶圈套扎组的EQ VAS评分优于芍倍注射组(P <0.05)。两组患者EQ VAS评分在术后3个月较术前提高,差异有统计学意义(P <0.001)。两组治疗有效率均为97.9%,治疗满意度比较差异无统计学意义(P> 0.05)。结论 内镜下芍倍注射术与胶圈套扎术对Ⅱ度内痔均具有良好的疗效,但前者在减轻术后肛门疼痛程度、降低肛门坠胀和术后第1周并发症发生率、减少治疗费用方面,具有一定的优势。

Objectives To compare and assess the clinical efficacy and safety of endoscopic Shaobei injection and rubber band ligation in the treatment of gradeⅡinternal hemorrhoids,and to offer clinical treatment recommendations.Methods A retrospective collection of clinical data involved 96 patients with gradeⅡinternal hemorrhoids who underwent either endoscopic Shaobei injection(n=48)or rubber band ligation(n=48)at the Endoscopic Surgery Department of the Sixth Affiliated Hospital of Sun Yat-sen University from December 2019 to March 2023.The postoperative adverse events(postoperative anal pain,anal distension,and anal edema),perioperative complications,treatment costs,quality of life evaluation,comprehensive efficacy and treatment satisfaction were compared between the two groups.Results In the Shaobei injection group,the VAS scores for postoperative pain on the first and seventh days were lower than those in the rubber band ligation group.The incidence of postoperative anal distension on the first day was significantly lower in the Shaobei injection group than in the rubber band ligation group(P<0.001).Within one week after surgery,the probability of bleeding in the Shaobei injection group was lower(P<0.05),but there were no significant differences in the incidence of urinary retention and fever between the two groups(P>0.05).The treatment costs of the Shaobei injection group was significantly less than that of the rubber band ligation group(P<0.001).At 3 months after surgery,the EQ VAS score in the rubber band ligation group was better than that in the Shaobei injection group(P<0.05).The EQ VAS scores of both groups at 3 months after surgery were significantly higher than those before surgery(P<0.001).The effective rate of treatment in both groups was 97.9%,and there was no significant difference in treatment satisfaction(P>0.05).Conclusion Both Shaobei injection and rubber band ligation exhibit positive efficacy in the treatment of gradeⅡinternal hemorrhoids.However,the former demonstrates distinct advantages in reducing postoperative anal pain,reducing anal distension and postoperative complications within one week,and lowering treatment costs.