Department of Surgery, General Surgery Unit, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria.
Department of Surgery, General Surgery Unit, Lagos University Teaching Hospital; Department of Surgery, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
Niger Postgrad Med J. 2020 Oct-Dec;27(4):311-316. doi: 10.4103/npmj.npmj_232_20.
The surgical treatment of internal haemorrhoids is yet to be fully elucidated. Rubber band ligation (RBL) and injection sclerotherapy (IS) are less invasive alternative day-case treatment options with lower morbidity than excisional haemorrhoidectomy.
This was a prospective study that compared the efficacy of RBL with 3% polidocanol IS in the treatment of Grades I to III internal haemorrhoids.
Sodergren haemorrhoid symptom severity (SHSS) scores of consecutive adult patients with internal haemorrhoids were calculated before and after each of three therapy sessions with RBL and IS. Outcome measures included SHSS scores after treatment, post-procedure pain and complication rates. Data were collated and analysed using SPSS version 23.
A total of 74 patients participated in the study with 37 patients in each treatment group. The RBL and IS groups were not statistically different in age (P = 0.506), weight (P = 0.117), height (P = 0.462), BMI (P = 0.153) and gender (P = 0.639). The mean SHSS scores for both groups before therapy (P = 0.876), at 4 weeks (P = 0.669), 8 weeks (P = 0.168) and 12 weeks (P = 0.391) after commencement of therapy were not statistically different. The SHSS scores at 12 weeks after treatment were statistically significantly lower than before treatment in both the groups (P < 0.01). The post-procedure pain score was significantly higher in the RBL than IS group after the first (P < 0.001) and second (P < 0.006) but not after the third therapy session (P = 0.501). The complication rates were low and not significantly different for the RBL and IS groups (5.7% versus 8.1%; P = 0.643).
The study concluded that RBL and IS are both effective and safe in the treatment of Grades I, II and III internal haemorrhoids.
内痔的手术治疗尚未完全阐明。橡皮圈结扎（RBL）和注射硬化疗法（IS）是侵入性较小的替代日间治疗选择，其发病率低于痔切除术。
本研究前瞻性比较了 RBL 与 3%聚多卡醇 IS 治疗 I 至 III 度内痔的疗效。
对连续接受 RBL 和 IS 三种治疗方案的成人内痔患者进行 Sodergren 痔症状严重程度（SHSS）评分。观察指标包括治疗后 SHSS 评分、术后疼痛和并发症发生率。数据采用 SPSS 23 版进行整理和分析。
共 74 例患者入组，每组 37 例。RBL 和 IS 组在年龄（P = 0.506）、体重（P = 0.117）、身高（P = 0.462）、BMI（P = 0.153）和性别（P = 0.639）方面无统计学差异。两组患者治疗前（P = 0.876）、4 周（P = 0.669）、8 周（P = 0.168）和 12 周（P = 0.391）时的 SHSS 评分无统计学差异。两组治疗后 12 周的 SHSS 评分均显著低于治疗前（P < 0.01）。RBL 组患者术后第 1 次（P < 0.001）和第 2 次（P < 0.006）疼痛评分显著高于 IS 组，但第 3 次治疗后疼痛评分差异无统计学意义（P = 0.501）。RBL 和 IS 组的并发症发生率均较低，差异无统计学意义（5.7%比 8.1%；P = 0.643）。
研究表明，RBL 和 IS 均能有效、安全地治疗 I 、 II 和 III 度内痔。
