Li Juan, Chen Yongcheng, Liao Sen, Lin Dezheng, Hu Jiancong, Zhong Qinghua, Deng Jiaxin, Zhang Jiawei, Guo Xuefeng
Department of General Surgery (Endoscopic Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, No. 26 Yuancun Erheng Road, Tianhe, Guangzhou, 510655, Guangdong, China.
Guangdong Provincial Key Laboratory of ColorCectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Surg Endosc. 2025 Mar;39(3):1555-1564. doi: 10.1007/s00464-024-11491-6. Epub 2025 Jan 6.
It is unknown whether Shaobei injection is superior to band ligation for endoscopic symptomatic hemorrhoid treatment. We compared the clinical efficacy, safety, and health economics of the two techniques.
This study aims to compare the efficacy, safety and health economics of endoscopic injection of Shaobei and endoscopic ligation in the treatment of grade I-IV symptomatic hemorrhoids.
This retrospective cohort study collected clinical data from 413 patients with grade I-IV symptomatic hemorrhoids treated with endoscopy between January 2019 and March 2023. Recurrence rate, postoperative complications, hospitalization costs, hospitalization time, postoperative quality of life (QoL), and postoperative satisfaction were compared between Shaobei injection (treatment group; n = 79) and band ligation (control group; n = 334) groups within 3 months postoperatively.
Before propensity score matching (PSM), the basic characteristics of patients significantly differed between groups (P < 0.05); no differences existed after PSM (Shaobei injection: n = 53; band ligation: n = 83). Recurrence rates did not differ between groups at 3 months postoperatively (P = 0.439). Postoperative symptom grading did not differ between groups (all P > 0.05) but was improved from baseline (all P < 0.001). However, the injection group experienced significantly less pain than the band ligation group on postoperative days 1 (P < 0.001) and 7 (P = 0.003). Significantly lower incidences were observed in the injection than in the ligation group for postoperative anal distention within 1 day (P < 0.001) and complications within 7 days (P < 0.001). No differences between groups were observed for other variables.
Endoscopic Shaobei injection is effective and safe for treating grade I-IV symptomatic hemorrhoids, with less postoperative discomfort and fewer postoperative complications than with band ligation.
尚不清楚芍倍注射液在内镜下治疗有症状痔方面是否优于橡皮圈套扎术。我们比较了这两种技术的临床疗效、安全性和卫生经济学。
本研究旨在比较内镜下芍倍注射与内镜下套扎术治疗Ⅰ-Ⅳ度有症状痔的疗效、安全性和卫生经济学。
这项回顾性队列研究收集了2019年1月至2023年3月间接受内镜治疗的413例Ⅰ-Ⅳ度有症状痔患者的临床资料。比较了芍倍注射组（治疗组；n = 79）和橡皮圈套扎组（对照组；n = 334）术后3个月内的复发率、术后并发症、住院费用、住院时间、术后生活质量（QoL）和术后满意度。
在倾向评分匹配（PSM）前，两组患者的基本特征有显著差异（P < 0.05）；PSM后无差异（芍倍注射组：n = 53；橡皮圈套扎组：n = 83）。术后3个月时两组的复发率无差异（P = 0.439）。两组术后症状分级无差异（所有P > 0.05），但均较基线有所改善（所有P < 0.001）。然而，注射组在术后第1天（P < 0.001）和第7天（P = 0.003）的疼痛明显低于橡皮圈套扎组。注射组术后1天内肛门坠胀（P < 0.001）和7天内并发症（P < 0.001）的发生率明显低于套扎组。其他变量在两组之间未观察到差异。
内镜下芍倍注射治疗Ⅰ-Ⅳ度有症状痔有效且安全，与橡皮圈套扎术相比，术后不适更少，术后并发症更少。
