内镜下多点套扎不同点数治疗Ⅱ～Ⅲ度内痔的临床效果分析OA

Objective To explore the influence of the therapeutic effect and adverse reactions of endoscopic rubber band ligation(ERBL)with different ligation bands for grade Ⅱ-Ⅲ internal hemorrhoids.Methods A total of 554 patients with internal hemorrhoids who received ERBL treatment at Meizhou People's Hospital from June 2020 to December 2024 were selected and divided into group A(4-5 bands)and group B(6-7 bands)based on the number of ligation bands.Due to significant differences in the distribution of internal hemorrhoid grades,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 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 scores for anal pain at 1h,24h,and 48h after surgery and the incidences of anal distension,defecation difficulty and urinary retention in group B were significantly higher than those in group A(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 internal hemorrhoid patients(P<0.05).Conclusion ERBL is safe and effective in the treatment of grade Ⅱ to Ⅲ internal hemorrhoids.For patients with internal hemorrhoids of the same grade,increasing the number of ligation bands does not improve the therapeutic effect,but it significantly increases the risk of adverse reactions such as postoperative pain,anal distension,and urinary retention.