内镜下不同套扎点位数治疗I~III度内痔的疗效及安全性分析

Efficacy and Safety Evaluation of Endoscopic Rubber Band Ligation at Different Sites for Grades I~III Internal Hemorrhoids

摘要: 目的：比较内镜内痔套扎治疗I~III度内痔时常规点位套扎和多点位套扎的疗效及安全性。方法：纳入2021年01月01日至2025年06月30日在青岛大学附属医院接受内镜内痔套扎治疗的94例内痔患者，按套扎点位分为常规套扎组(2~3环)，多点套扎组(4~7环)，分析两组临床效果及术后不良反应的不同。结果：术后6周常规套扎组临床有效率为91.49%，多点套扎组有效率92.5%，术后18周常规套扎组临床有效率89.36%，多点套扎组有效率88.75%，2组间术后6周、术后18周的临床有效率无统计学差异(P > 0.05)。术后不良反应以疼痛发生最多，在疼痛发生率、疼痛持续时间及疼痛评分方面2组比较无统计学差异(P > 0.05)；术后不良反应发生率次之的为排尿困难，多点套扎组排尿困难发生率高于常规套扎组(P = 0.013)。结论：常规套扎母痔区3环即可满足内痔的临床治疗需求，增加套扎点位会增加术后排尿困难的发生风险，但本文为回顾性探索性结论，尚需前瞻性研究进一步验证。

Abstract: Objective: To evaluate the efficacy and safety of conventional point ligation and multi-point ligation for treating grades I~III internal hemorrhoids. Methods: A total of 94 patients with internal hemorrhoids who underwent endoscopic rubber band ligation at the Affiliated Hospital of Qingdao University between January 1, 2021, and June 30, 2025, were included. Patients were divided into a conventional ligation group (2~3 bands) and a multi-point ligation group (4~7 bands). The study compared the clinical efficacy and adverse reactions between the two groups. Results: At 6 weeks postoperatively, the clinical efficacy was 91.49% in the conventional group and 92.5% in the multi-point group. At 18 weeks, efficacy rates were 89.36% and 88.75%, respectively. There were no statistically significant differences in clinical efficacy between the groups (P > 0.05). Postoperative pain was the most common adverse reaction, with no significant differences in incidence, duration, or pain scores between groups (P > 0.05). Urinary difficulty was the second most frequent complication, with a higher incidence in the multi-point group (P = 0.013). Conclusion: Conventional ligation of the primary hemorrhoidal zones with 3 bands is sufficient to meet the clinical treatment needs for internal hemorrhoids. Increasing the number of ligation sites may raise the risk of postoperative dysuria.