次侧方内括约肌切开加双缘结扎术治疗Ⅲ期肛裂临床观察(附150例报告)  

Clinical observation of Lateral Sub incision of Internal Sphincter Plus Ligation of Both Borders in The Treatment of 150 patients with Stage Ⅲ Anal Fissure

作　　者：肖秋平[1] 黄卫平[1] 林金荣[1] 李庚[1] 

机构地区：[1]福建中医药大学附属厦门中医院肛肠科,福建厦门361000

出　　处：《结直肠肛门外科》2014年第1期37-39,共3页Journal of Colorectal & Anal Surgery

摘　　要：目的观察次侧方内括约肌切开加双缘结扎术治疗Ⅲ期肛裂临床疗效及其对肛门功能的影响。方法治疗组选取Ⅲ期肛裂患者150例,均采用次侧方内括约肌切开加双缘结扎术治疗,观察创口愈合时间、随访6个月的复发率及测定手术前后肛门直肠压力,并与健康对照组比较。结果所有患者均痊愈出院,创口平均愈合时间(16±2.87)d,随访6个月无复发病例;术前肛管静息压较正常人显著升高(P<0.05),肛管舒张压较前显著降低(P<0.05),肛管最大收缩压及肛管自主收缩持续时间与正常人比较无明显差异(P>0.05);术后肛管静息压较术前明显降低(P<0.05),肛管舒张压较前明显升高(P<0.05),肛管最大收缩压及肛管自主收缩持续时间与术前比较无明显差异(P>0.05);术后肛管静息压、肛管舒张压、肛管最大收缩压及肛管自主收缩持续时间与正常人比较无明显差异(P>0.05)。结论次侧方内括约肌切开加双缘结扎术治疗Ⅲ期肛裂疗效显著,能有效地解除内括约肌痉挛,改善肛裂溃疡面的供血不足,促进肛裂的愈合。Objective To observe the efficacy of Lateral Sub incision of internal sphincter plus ligation of both borders in the treatment of Stage Ⅲ Anal Fissure. Methods 150 patients with Stage Ⅲ Anal Fissure were included. They were treated with lateral sub incision of internal sphincter plus ligation of both borders. The wound healing time and the recurrence rate after 6 months of follow up were observed, and the anorectal pressure before and after operation were measured. The health volunteers were selected as control group. Results All the patients were cured. The average wound healing time was （16±2.87）d, and no recurrence after followed up in 6 months. Compared with control group, the preoperative anal resting pressure after 6 months of follow up and anal resting pressure significantly reduced in the treatment group （ P 〈0.05 ）, and there was no significant differences in preoperative maximal anal contraction pressure and anal voluntary contraction duration （ P 〉0.05 ）. The postoperative anal resting pressure decreased obviously compared with pre-operation （ P 〈0.05 ）, and the anal diastolic pressure increased significantly （ P 〈0.05）. There was no obvious difference with regard to maximal anal contraction pressure and anal voluntary contraction duration before and after operation （ P 〉0.05）, and there was no significant differences in postoperative anal resting pressure, anal diastolic pressure, maximal anal contraction pressure and anal voluntary contraction duration between treatment group and control （ P〉0.05）. Conclusion Lateral sub incision of internal sphincter plus ligation of both borders is effective in the treatment of stage Ⅲ anal fissure. The method can relieve anal sphincter spasm to improve the blood circulation and promote healing of the anal fissure.

关 键 词：肛裂 次侧切术 双缘结扎术 肛管直肠压力测定 

分 类 号：R657.14[医药卫生—外科学]