通讯作者: 陈奕金, 879561010@qq.com

DOI：10.12201/bmr.202603.00059

Clinical Efficacy Analysis of Different Numbers of Endoscopic Multi-Band Ligation in the Treatment of Grade Ⅱ-Ⅲ Internal Hemorrhoids

• 摘要：目的 探讨内镜下多点套扎的不同点数对Ⅱ~Ⅲ度内痔内镜下套扎治疗效果与不良反应的影响，以指导内痔的个体化治疗。方法 选取梅州市人民医院2020年6-2024年12月连续收治的行多点套扎的Ⅱ~Ⅲ度内痔患者554例，根据单次套扎点数分为分为A组（4~5环）、B组（6~7环）；因内痔分度分布差异显著（P<0.01），采用分层分析消除混杂，分别在 Ⅱ 度、Ⅲ 度内痔亚组内对比两组疗效及术后不良反应发生情况，并通过多因素Logistic回归模型分析疗效和术后不良反应的独立危险因素。结果 总体及分层分析均显示，A、B两组的治疗总有效率、术后出血发生率比较，差异均无统计学意义（P>0.05）；B组术后1h、24h、48h肛门疼痛视觉模拟评分（visual analogue scale, VAS），以及肛门坠胀、排便困难、尿潴留等发生率亦显著高于A组（P<0.05）。多因素Logistic回归分析结果显示，套扎点数是Ⅱ度、Ⅲ度内痔患者术后疼痛、肛门坠胀、尿潴留发生的独立危险因素（P<0.05），性别、年龄、病程对疗效及上述不良反应均无显著独立影响（P>0.05）。结论 内镜下多点套扎治疗Ⅱ~Ⅲ度内痔安全有效。在同一分度的多点套扎中增加套扎点数未提升治疗效果，但会显著加重术后疼痛、肛门坠胀、尿潴留等不良反应发生风险，套扎点数为术后相关不良反应的独立危险因素。

  关键词： 内痔 多点套扎 套扎点数 疗效 不良反应; ; ; ; 

   

  Abstract: Abstract Objective To investigate the impact of different numbers of ligation bands on the efficacy and adverse reaction profiles of endoscopic multi-band ligation for grade II-III internal hemorrhoids, and to guide the individualized treatment of this condition.Methods A retrospective analysis was conducted on the clinical data of 554 consecutive patients with grade Ⅱ-Ⅲ internal hemorrhoids admitted between June 2020 and December 2024. Patients were divided into two groups based on the number of ligation bands: Group A (4-5 bands), and Group B (6-7 bands). Due to significant differences in the distribution of hemorrhoid grades between groups (P<0.01), stratified analysis was performed to control for confounding. Efficacy and postoperative adverse reactions were compared within the grade Ⅱ and grade Ⅲ subgroups. Multivariate logistic regression analysis was performed to determine the independent risk factors affecting treatment efficacy and the incidence of postoperative adverse reactions. Results Both overall and stratified analyses showed no statistically significant difference in total efficacy rates or incidence of postoperative bleeding between group A and group B (P>0.05). Visual analogue scale (VAS) scores for anal pain at 1 h, 24 h, and 48 h in Group B were significantly higher than those in Group A (P<0.05). The incidences of anal distention,difficult defecation, and urinary retention were also significantly higher in Group B (P<0.05). Multivariate logistic regression indicated that the number of ligation bands was an independent risk factor for postoperative pain, anal distention, and urinary retention in both grade Ⅱ and grade Ⅲ hemorrhoid patients (P<0.05). Gender, age, and disease duration showed no significant independent influence on treatment efficacy or the aforementioned adverse reactions (P>0.05). Conclusion Endoscopic multi-band ligation is safe and effective for grade Ⅱ-Ⅲ internal hemorrhoids. Increasing the number of ligation bands within the same hemorrhoid grade does not improve therapeutic efficacy, but raises the risk of postoperative adverse reactions, including pain, anal distention, and urinary retention. The number of ligation bands is identified as an independent risk factor for these postoperative adverse events.

  Key words: Internal Hemorrhoids; Endoscopic Multi-band Ligation; Number of Ligation Bands; Efficacy; Adverse Reactions

  提交时间：2026-03-17

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• 序号	提交日期	编号	操作
  1	2026-03-11	10.12201/bmr.202603.00059V1	下载

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