CO_2激光结合亚甲蓝局麻扩肛术治疗Ⅲ期肛裂的临床观察  

The effects of combined using CO_2 laser and anal dilatation by local anesthesia of methylene blue for stage Ⅲ anal fissure

作　　者：万凡[1] 何茂林[1] 

机构地区：[1]湖北省军区门诊部,湖北武汉430070

出　　处：《结直肠肛门外科》2014年第3期182-184,共3页Journal of Colorectal & Anal Surgery

摘　　要：目的 观察和评价CO2激光结合亚甲蓝局麻扩肛术治疗Ⅲ期肛裂的临床疗效.方法 将102例Ⅲ期肛裂患者随机分为两组,治疗组50例采用CO2激光结合0.1％亚甲蓝局麻下扩肛术,对照组52例采用内括约肌开放式侧切术.观察两组患者肛裂治愈率、愈合时间及术后疼痛、出血等并发症.结果 两组的治愈率及愈合时间差异无统计学意义（P＞0.05）;术后24～48h的疼痛比较,治疗组主要为Ⅰ级（24例）,对照组主要为Ⅱ级（35例）,两组疼痛差异有统计学意义（P＜0.05）,治疗组疼痛较轻;术后出血比较,治疗组主要为0级（42例）,对照组主要为Ⅰ、Ⅱ级（36例）,两组术后出血差异有统计学意义（P＜0.05）,治疗组出血较少.结论 CO2激光结合亚甲蓝局麻扩肛术治疗Ⅲ期肛裂的临床疗效与传统的内括约肌开放式侧切术相仿,但术后并发症更少,是基层治疗Ⅲ期肛裂的理想手术方式.Objective To observe the effects of combined using CO2 laser and anal dilatation by local infiltrating anesthesia of methylene blue on stage Ⅲ anal fissure.Methods One hundred and two patients with stage Ⅲ anal fissure were randomly divided into two groups：50 patients in the treatment group were treated by CO2 laser and anal dilatation by local infiltrating anesthesia of 0.1％ methylene blue; 52 patients in control group were treated by lateral incision of the internal sphincter and anal dilatation.The curative rate,the average healing time,the degree of pain and bleeding in two groups were compared after surgery.Results The curative rate was 96％ and 94.2％,respectively.There was no significant difference of curative rate in the two groups.In 24h to 48h after surgery,the degree of pain of most patients in treatment group was gradeⅠ （24 cases）,but those in control group was gradeⅡ （35 cases）（P＜0.05）.The degree of bleeding after surgery in treatment group was grade 0 （42 cases） and those in control group was grade Ⅰ and Ⅱ （36 cases）.There was statistical difference in the degree of bleeding after surgery between the two groups（P ＜0.05）.Conclusion Combined using CO2 laser and anal dilatation by local infiltrating anesthesia of methylene blue has similar clinical outcomes with the traditional method of lateral internal sphincter incision.This procedure could reduce the postoperative complications and it was a suitable method for treatment of stage Ⅲ anal fissure.

关 键 词：肛裂 CO2激光 亚甲蓝 扩肛术 

分 类 号：R657.1[医药卫生—外科学]