目的　探讨经自然腔道取标本手术治疗内痔伴直肠黏膜内脱垂的疗效及安全性。方法　选取2022年1月—2024年1月收治的100例内痔伴直肠黏膜内脱垂患者,采用随机数字表法分为对照组和研究组,每组各50例。对照组行传统腹腔镜手术,观察组行经自然腔道取标本手术。对两组手术相关指标[手术用时、术中出血量、术后视觉模拟评分法（VAS）评分以及术后住院时间]、手术前后Wexner便秘评分和术后并发症（便血、发热、尿潴留）发生情况进行对比。结果　两组术中出血量差异无统计学意义（P>0.05）;研究组手术时间长于对照组,术后疼痛评分（VAS评分）低于对照组,术后住院时间短于对照组,差异均有统计学意义（P<0.05）。相较于手术前,两组手术后8周Wexner便秘评分均有明显下降（P<0.05）,两组手术后8周,组间比较无明显差异（P>0.05）。两组术后并发症发生情况无明显差异（P>0.05）,且在术后6个月随访中,两组均无复发。结论　经自然腔道取标本手术治疗内痔伴直肠黏膜内脱垂在减轻术后疼痛、缩短住院时间方面具有明显优势,且无复发率,为临床提供了一种安全有效的治疗新选择。

Objective To investigate the efficacy and safety of natural ori-fice specimen extraction surgery （NOSES） for internal hemorrhoids with rectal mucosal prolapse. Methods A total of 100 patients with internal hemorrhoids and rectal mucosal prolapse admitted to our hospital from January 2022 to January 2024 were selected and divided into a control group and a study group by random number table method, with 50 patients in each group. The control group underwent traditional laparoscopic surgery, while the observation group underwent NOSES. Surgical related indicators [operation time, intraoperative blood loss, postoperative visual analogue scale （VAS） score, and postoperative hospital stay], preoperative and postoperative Wexner constipation scores, and postoperative complications （hematochezia, fever, and urinary retention） were compared between the two groups. Result There was no significant difference in intraoperative bleeding between the two groups （P>0.05）. The study group had significantly longer operation time, lower postoperative pain （VAS） scores, and shorter hospital stay than the control group （P<0.05）. Compared with before surgery, both groups showed a significant decrease in Wexner constipation scores 8 weeks after surgery （P<0.05）, while there was no significant difference between the two groups 8 weeks after surgery （P>0.05）. There was no significant difference in the incidence of postoperative complications between the two groups （P>0.05）, and there was no recurrence in either group during the 6-month follow-up after surgery. Conclusion NOSES for internal hemorrhoids with rectal mucosal prolapse has significant advantages in reducing postoperative pain and shortening hospital stay, with no recurrence rate, providing a safe and effective new treatment option for clinical practice.