两种术式治疗肛裂前后肛管直肠压变化的比较  

Comparison on the Changes of Anorectal Pressure before and after Treatment of Anal Fissure with Two Different Therapies

作　　者：李东平[1] 文丽娟[2] 郝秀艳 

机构地区：[1]成都中医药大学附属医院肛肠科,四川成都610072 [2]四川省凉山州中西医结合医院,四川西昌615000 [3]山东省烟台白石肛肠医院,山东烟台264006

出　　处：《中国肛肠病杂志》2011年第11期13-14,共2页Chinese Journal of Coloproctology

摘　　要：通过对两种术式治疗肛裂前后肛管直肠压的变化观察，探讨可能造成肛裂术后肛门失禁的原因，为寻找更优的手术方法提供依据。将确诊的100例肛裂患者随机分成治疗组和对照组，治疗组50例采用肛门内括约肌侧位切断术，对照组50例采用肛门内括约肌后位切断术。对两种治疗肛裂的术式手术前后肛管直肠压、疗程及术后并发症、术后疼痛、术后排便等指标进行观察统计。结果显示，治疗后两组患者症状评分均较治疗前降低，两组近期疗效、术后并发症（创13水肿、创口感染、肛门狭窄、术后排尿困难）、术后排便情况差异无统计学意义（P〉0．05），在疗程、术后出血、术后疼痛及肛管直肠压方面治疗组优于对照组（P〈0．05）。结果表明，肛门内括约肌侧位切断术较肛门内括约肌后位切断术治疗肛裂具有创口小、愈合快、痛苦小、并发症少、安全性高等优点。Through observation on the changes of anorectal pressure before and after the treatment of anal fissure with two different therapies, this study explores possible causes indusing postoperative anus incontinence,so that provides the basis to search for more optimum procedure for anal fissure. The confirmed 100 patients with anal fissure were randomly divided into two groups,i, e treatment group（ n =50） subjected to lateral incision of anal internal sphincter, control group to posterior incision of that;then treatment course, postoperative complication, postoperative pain, postoperative defecation status, and the changes of anorectal pressure before and after two procedures were recorded and analysed. As results, after treatment the score of symptoms in both groups all decreased than before treatment;in shorter-term therapeutic effect, postoperative complication（wound edema,wound infection,anus stenosis and postoperative dysuria）, and postoperative defecation status there was no statistical difference（ P 〉0.05） between both groups,while,in treat- ment course,postoperative bleeding, pain and anorectal pressure, treatment group was superior to control group（ P 〈0.05）. Results show that compared with anal internal sphincter posterior incision, lateral incision in the treatment of anal fissure has such advantages as less wound, faster healing, milder pain, less complication and higher safety, etc.

关 键 词：肛裂 内括约肌侧位切断术 肛管直肠压 

分 类 号：R657.14[医药卫生—外科学]