目的

探讨不同出针长度在透明帽辅助内镜下III 度内痔硬化术中的应用价值。

方法

收集2019 年1 月至2022 年12 月期间，内蒙古包头市中心医院东院区收治的120 例Ⅲ度内痔患者的临床资料，根据治疗方式随机分成三组，每组40 例，其中A 组：内痔硬化治疗（出针长度9 mm）、B 组：内痔硬化治疗（出针长度4 mm）、C 组：传统手术治疗。 比较各组在手术时间、手术费用、住院时间、临床疗效和并发症等方面的差异。

结果

硬化组（A 组+B 组）在内痔脱出及内痔出血改善情况方面的总有效率分别为：85%、91.25%，而传统手术组则分别为：90%、97.5%，两者之间的差异，不具有统计学意义（P＞0.05）；硬化组（A 组+B 组）的并发症发生率为8.75%，低于传统手术组的25%，差异具有统计学意义（P＜0.05）。 亚组分析发现，A 组和B 组在手术时间、住院时间、手术费用方面均优于C 组，A 组和B 组之间无明显统计学差异。 在内痔脱出改善方面，A 组、B 组、C 组的治疗总有效率分别为95%、75%、90%，A 组明显优于B 组（95% vs. 75%），差异具有统计学意义；在内痔便血改善方面，A 组、B 组、C 组的治疗总有效率分别为95%、87.5%、97.5%，A 组与B 组比较，差异无统计学意义（95% vs. 87.5%）。

结论

透明帽辅助内镜下硬化术在III 度内痔治疗中效果确切，并发症发生率低，优于传统手术治疗方式，值得临床推广应用。 另外，在内痔硬化术中，出针长度9 mm 相较于出针长度4 mm 其在改善内痔脱出症状方面更具优势。

Objective

To explore the clinical application value of different needle extension lengths in cap-assisted endoscopic sclerotherapy for third-degree internal hemorrhoids.

Methods

The clinical data of 120 patients with third-degree internal hemorrhoids，admitted to Baotou Central Hospital Inner Mongolia from January 2019 to December 2022，were collected and randomly divided into three groups，with 40 cases in each group.Group A underwent sclerotherapy with needle extension length of 9 mm，Group B underwent sclerotherapy with needle extension length of 4 mm，and Group C underwent traditional surgical treatment.The differences in operation time，surgical cost，hospital stay，clinical efficacy，and complication rates were compared among the groups.

Results

The improvement rates of internal hemorrhoid prolapse and internal hemorrhoid hematochezia in Group A+B were 85%，91.25%，compared to 90%，97.5% in Group C，both with no significant differences （P＞0.05）.The complication rates in Group A+B was 8.75%，which was obviously lower than that in Group C（25%） ，and the differences was statistically significant （P＜0.05）.In subgroup analysis，Group A and Group B were both superior to Group C in terms of operation time，hospital stay，surgical cost，however，there were all no significant statistical difference between Group A and Group B.In terms of the improvement rate of internal hemorrhoid prolapse，Group A was significantly better than Group B（95% vs. 75%）.While，there was no significant statistical difference between Group A and Group B in internal hemorrhoid hematochezia （95% vs. 87.5%）.

Conclusion

Endoscopic sclerotherapy is effective for the management of third-degree internal hemorrhoids，with a low incidence of complication.It is superior to traditional surgical treatment and is worthy of clinical promotion and application.In addition，in internal hemorrhoid sclerotherapy，needle extension length of 9 mm is more valuable in improving the symptoms of prolapse of internal hemorrhoids than needle extension length of 4 mm.