套扎术联合不同聚桂醇硬化疗法治疗Ⅰ～Ⅲ度内痔的效果和安全性对比OA

Objective To compare the clinical efficacy and safety of band ligation combined with lauromacrogol foam sclerosant versus liquid sclerosant in the treatment of grade Ⅰ-Ⅲ internal hemorrhoids,so as to provide evidence-based basis for clinical treatment regimen selection.Methods A total of 82 patients with grade Ⅰ-Ⅲ internal hemorrhoids admitted to Affiliated Hospital of Youjiang Medical University for Nationalities from January 2022 to December 2023 were selected as research subjects.They were divided into foam therapy group and liquid therapy group using a random number table,with 41 cases in each group.Both groups were given endoscopic band ligation.On this basis,the liquid therapy group were injected with lauromacrogol liquid sclerosant,while the foam therapy group were injected with lauromacrogol foam scle-rosant(liquid-to-gas ratio 1∶4).The treatment outcomes of overall and different grades of internal hemorrhoids,total num-ber of injection points,sclerosant dosage,postoperative bleeding,perianal pain degree at 24 h after surgery,anorectal dynamic parameters(maximum tolerated volume of rectum[MTV],maximum systolic pressure of anal canal[MSP],and rectal resting pressure[RRP])at 1 month after treatment,anal function scores,incidence of complications,hospitalization costs,length of hospital stay,as well as recurrence rate and quality of life scores at 6 months and 12 months after surgery were compared between the two groups.Results The overall treatment effect of the foam therapy group was better than that of the liquid therapy group,and the total number of injection points and total sclerosant dosage were less than those of the liquid therapy group(P＜0.001).Stratified analysis by internal hemorrhoid grade showed that in grade Ⅰ,Ⅱ,and Ⅲinternal hemorrhoid subgroups,the efficacy of the foam therapy group was better than that of the liquid therapy group with the same grade,and the sclerosant dosage and number of injection points were lower(P＜0.05).Postoperative bleeding and perianal pain at 24 h after surgery in the foam therapy group were milder than those in the liquid therapy group(P＜0.05).At 1 month after treatment,MTV and MSP in the foam therapy group were lower than those in the liquid therapy group,while RRP was higher than that in the liquid therapy group(P＜0.05).The anal continence function score and anal sensory func-tion score in the foam therapy group were lower than those in the liquid therapy group(P＜0.001).The total incidence of complications in the foam therapy group was 7.32％,which was lower than that in the liquid therapy group(24.39％)(P=0.034).There was no significant difference in length of hospital stay between the two groups(P＞0.05),but the hospitaliza-tion cost in the foam therapy group was lower than that in the liquid therapy group(P＜0.001).Follow-up at 6 months and 12 months after surgery showed that the recurrence rate of the foam therapy group was lower than that of the liquid therapy group,and the quality of life score was higher than that of the liquid therapy group(P＜0.05 or 0.001).Conclusion Band ligation combined with lauromacrogol foam sclerosant has definite efficacy in the treatment of grade Ⅰ-Ⅲ internal hemor-rhoids.It can reduce sclerosant dosage,alleviate postoperative bleeding and pain,improve anorectal function,reduce the incidence of complications and medical costs,and has a lower long-term recurrence rate,with better safety and economic benefits,which is worthy of clinical promotion and application.