改良纵切横缝术治疗慢性肛裂的临床疗效观察  

To observe the clinical effect of modified longitudinally cut transverse suture operation in the treatment of chronic anal fissure

作　　者：詹兴云 闫作斌[1] 刘文全 黄智[1] Zhan Xingyun Yan Zuobin Liu Wenquan Huang Zhi.(Department of General Surgery, People＇s Hospital of Wanning, Wanning, Hainan, 571500, China)

机构地区：[1]万宁市人民医院普通外科,海南万宁571500

出　　处：《结直肠肛门外科》2017年第4期494-497,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的观察改良纵切横缝术治疗慢性肛裂的临床疗效。方法纳入2012年11月至2014年11月本院收治的90例Ⅱ~Ⅲ期慢性肛裂患者为研究对象,随机分为观察组(采取改良纵切横缝术,n=45)及对照组(行常规纵切横缝术,n=45)。比较两组治疗总有效率、手术前后肛管直径及切口愈合时间,记录手术前后肛管静息压及肛管最大收缩压,以及术后并发症发生率,并通过电话随访半年记录两组术后复发率。结果两组治疗总有效率均为100.00%。两组术前肛管直径、直肠静息压、肛管最大收缩压比较差异无统计学意义(P>0.05)。术后,两组肛管直径较术前均显著增大(均P<0.05),组间差异无统计学意义(P>0.05)。观察组切口愈合时间显著短于对照组(P<0.05)。术后,两组肛管静息压显著低于术前(P<0.05),肛管最大收缩压均高于术前(均P<0.05),两组肛管静息压、肛管最大收缩压组间比较差异均无统计学意义(均P>0.05)。观察组并发症总发生率为17.8%,显著低于对照组的44.4%(P<0.05)。随访半年,观察组失访2例,对照组失访1例,均无复发患者,两组复发率差异无统计学意义(P>0.05)。结论改良纵切横缝术与传统纵切横缝术治疗Ⅱ~Ⅲ期慢性肛裂疗效相当,前者更利于缩短切口愈合时间及降低术后并发症发生率。Objective To investigate the clinical efficacy of modified longitudinally cut transverse suture in the cure of chronic anal fissure. Methods 90 chronic anal fissure patients with stage II and III from November 2012 to November 2014 in our hospital were selected as the research subjects and randomly divided into observation group（modified longitudinally cut transverse suture operation,n = 45） and control group（routine longitudinally cut transverse suture operation, n = 45）. The total efficiency, anal canal diameter and incision healing time, anal resting pressure and maximal systolic blood pressure before and after the operation, the incidence of postoperative complications, and the postoperative recurrence rate in half one year by telephone follow-up in the two groups were compared. Results The total effective rate was 100% in the two groups. And there was no significant difference between the two groups in preoperative anal canal diameter, rectal resting pressure, and anal maximum systolic pressure（P 〈 0.05）. The diameter of anal canal in two groups was significantly higher than that before operation（all P 〈 0.05）, while the diameter of anal canal after operation has no significant difference between groups（P 〈 0.05）. The healing time of the observation group was significantly shorter than that of the control group（P 〈 0.05）. The anal resting pressure in the two groups after operation was obviously lower than that before operation（P 0.05）, and anal maximal systolic blood pressure was higher than before（P 〈 0.05）, however, the difference of the anal resting pressure and anal maximal contraction pressure in the two groups were not statistically significant（P 〈 0.05）. The total incidence of complications in the observation group was 17.8%, significantly lower than 44.4% in the control group（P 〈 0.05）. During the half a year of follow-up the observation group lost 2 cases, the control group lost 1 cases, there were no recurrence patients, the recurrence rate of t

关 键 词：改良纵切横缝术 慢性肛裂 疗效 

分 类 号：R657.14[医药卫生—外科学]