探讨内镜下套扎及硬化治疗Ⅰ~Ⅱ度内痔的远期有效性和安全性。

回顾性分析2019年1月至2021年6月中国人民解放军联勤保障部队第九六〇医院收治的Ⅰ~Ⅱ度内痔患者的临床资料，按不同内镜治疗方式分为套扎组（32例）、硬化组（45例），随访36~63个月，中位随访时间47.5个月，比较两组的治疗效果、复发情况、满意度、并发症发生情况。

套扎组治愈率、显效率、总有效率分别为84.4%、12.5%、96.9%，硬化组分别为77.8%、20.0%、97.8%，两组比较差异均无统计学意义（P>0.05）。治疗有效的患者中，套扎组的复发率高于硬化组（22.6%比13.6%），但差异无统计学意义（P>0.05）。套扎组中位复发时间为13.5个月，硬化组中位复发时间为12.0个月，套扎组的满意度为93.8%，硬化组的满意度为95.6%，差异均无统计学意义（P>0.05）。套扎组术后肛门疼痛、肛门坠胀感明显较硬化组严重，发生率分别为41.6%比2.2%、56.2%比6.7%，差异均有统计学意义（P<0.05）；两组术后出血、发热发生率较低，差异无统计学意义（P>0.05）；随访期内，套扎组有3例术后发生肛瘘及肛周脓肿，分别发生于术后1、6、12个月，均追加外科手术后治愈，硬化组无此类情况发生。

套扎与硬化术治疗Ⅰ~Ⅱ度内痔均具有良好的治疗效果，二者有效率、复发率相近，但硬化治疗的术后并发症发生率更低。对Ⅰ~Ⅱ度这类较轻的内痔，硬化治疗可能更具优势。

To investigate the long-term efficacy and safety of endoscopic ligation and sclerotherapy for grade Ⅰ-Ⅱ internal hemorrhoids.

Clinical data of patients with grade Ⅰ-Ⅱ internal hemorrhoids admitted to the 960th Hospital of Chinese PLA Joint Logistics Support Force from January 2019 to June 2021 were retrospectively analyzed. They were divided into ligation group (32 cases) and sclerotic group (45 cases) according to different endoscopic treatment methods. The follow-up time was 36-63 months, with a median follow-up time of 47.5 months. The therapeutic effect, recurrence, satisfaction and complications of the two groups were compared.

The cure rate, effective rate and total effective rate of the two groups were compared, which were 84.4%, 12.5% and 96.9% in the ligation group and 77.8%, 20.0% and 97.8% in the sclerotic group, respectively. There was no statistically significant difference between the two groups (P>0.05). Among the patients with effective treatment, the recurrence rate in the ligation group was higher than that in the sclerotic group (22.6% vs. 13.6%), but there was no statistically significant difference (P>0.05). The median recurrence time was 13.5 months in the ligation group and 12.0 months in the sclerotic group. Satisfaction was 93.8% in the ligation group and 95.6% in the sclerotic group, and there was no statistically significant difference between the two groups (P>0.05). Postoperative anal pain and anal distension in the ligation group were significantly more severe than those in the sclerotic group (41.6% vs. 2.2%, 56.2% vs. 6.7%), with a statistically significant difference (P<0.05). The incidence of postoperative hemorrhage and fever was lower between the two groups, but there was no statistical difference (P>0.05). During the follow-up period, there were 3 cases of anal fistula and perianal abscess in the ligation group, which occurred 1 month, 6 months, and 12 months after surgery, respectively, and were cured after additional surgery, while no such cases occurred in the sclerotic group.

Both ligation and sclerotherapy have excellent curative effect in the treatment of grade Ⅰ-Ⅱ internal hemorrhoids, with similar effective rate and recurrence rate, but sclerotherapy has a lower incidence of postoperative complications. For mild internal hemorrhoids such as grade Ⅰ-Ⅱ, sclerotherapy may be more advantageous.