肛裂后位切扩术与侧位切扩术疗效比较  

Efficacy Observation and Option between Posterior Sphincterotomy and Lateral Sphincterotomy for Anal Fissure

作　　者：苏鸿文[1] 游志华[1] 

机构地区：[1]福建医科大学附属协和医院,福建福州350001

出　　处：《世界中西医结合杂志》2011年第9期784-786,共3页World Journal of Integrated Traditional and Western Medicine

摘　　要：目的探讨肛裂后位切扩术与侧位切扩术术式的临床选择,寻求肛裂的最佳手术方法。方法将120例肛裂患者随机分成Ⅰ组和Ⅱ组,Ⅰ组用肛裂后位切扩术治疗,Ⅱ组用肛裂侧位切扩术治疗,对两组患者的术后疗效、愈合时间、术后并发症等进行观察分析。结果后位切扩术组肛裂痊愈率为89.9%,显效率6.8%,有效率3.3%,总有效率100%;侧位切扩术痊愈率为77.1%,显效率1.6%,有效率11.5%,无效率9.8%,总有效率为90.2%。结论对于Ⅱ-Ⅲ期肛裂,尤其是合并皮下瘘管、肛乳头肥大等情况下首选后位切扩术;而侧位切扩术由于对肛管损伤小,痊愈时间短,故对于Ⅰ期肛裂患者可首选用侧位切扩术。在临床的选择应用上,应根据患者的具体情况,个体化制定手术方案,尽量减少手术创伤所带来的并发症。Objective To explore the clinical option between posterior sphincterotomy and lateral sphincterotomy for anal fissure so as to seek the best surgical method in treatment.Methods 120 cases of anal fissure were randomized into No.1 group and No.2 group.In No.1 group,the posterior sphincterotomy was applied and in No.2 group,the lateral sphincterotomy was adopted.The observation and analysis were done on the postoperative efficacy,healing time,postoperative complication and others between two groups.Results In the group with posterior sphincterotomy,the curative rate was 89.9%,the remarkably effective rate 6.8%,the effective rate 3.3% and the total effective rate 100%.In the group with lateral sphincterotomy,the curative rate was 77.1%,the remarkably effective rate 1.6%,the effective rate 11.5%,the failure rate 9.8 and the total effective rate 90.2%.Conclusion For anal fissure at Ⅱ to Ⅲ stage,especially the cases complicated with subcutaneous fistula,anal papillae hypertrophy and others,the posterior sphincterotomy is the first option.Because of its less anal injury and short recovery time,the lateral sphincterotomy is the first choice for anal fissure at I stage.In clinical application,the surgical program should be set up individually according to the specific situation of patient so as to minimize the complications caused by surgical trauma.

关 键 词：肛裂 手术 疗效观察 

分 类 号：R657.14[医药卫生—外科学]