改良后纵切横缝内括约肌切断术治疗肛裂的临床效果观察  

Effect of modified longitudinal incision and transverse suture internal sphincterotomy in treating anal fissure

作　　者：甄彦龙[1] Zhen Yanlong(Department of Anorectal Diseases,Baoji Traditional Chinese Medicine Hospital,Baoji,Shaanxi,721001,China)

机构地区：[1]宝鸡市中医医院肛肠科,陕西宝鸡721001

出　　处：《结直肠肛门外科》2018年第5期491-495,共5页Journal of Colorectal & Anal Surgery

基　　金：宝鸡市社会发展领域自筹经费科技计划项目(编号:2015B108)

摘　　要：目的探讨改良后纵切横缝内括约肌切断术治疗肛裂的临床效果。方法将本院2014年3月至2016年9月收治的86例肛裂患者按随机数表法分为观察组(接受改良后纵切横缝内括约肌切断术)与对照组(接受开放式内括约肌切断术),每组各43例。比较两组临床疗效、手术相关指标、术后切口疼痛程度、排尿障碍情况、切口感染率,术后随访6个月,记录疗效及复发情况。结果两组总有效率比较差异无统计学意义(P> 0.05)。观察组创面愈合时间、住院时间均短于对照组,差异均有统计学意义(均P<0.05)。两组手术时间、术中出血量、肛周水肿时间差异均无统计学意义(均P> 0.05)。观察组在减轻术后切口疼痛程度、排尿障碍程度方面总体均优于对照组,差异均有统计学意义(均P<0.05)。两组切口感染发生率差异无统计学意义(P> 0.05)。随访6个月,两组均无复发病例,且控制排便功能良好,全部治愈。结论改良后纵切横缝内括约肌切断术治疗肛裂效果良好,与开放式内括约肌切断术相比,有利于减轻术后疼痛、减少术后排尿障碍及促进患者康复。Objective To investigate the effect of modified longitudinal incision and transverse suture internal sphincterotomy in treating anal fissure. Methods 86 patients with anal fissure who were treated in our hospital from March 2014 to September 2016 were assigned using random number table to treatment group（received modified longitudinal incision and transverse suture internal sphincterotomy） and control group（received open internal sphincterotomy）, with 43 patients in each group. Clinical effectiveness, indices related to operation, postoperative pain at incision, difficulties in urination, and incision infection were compared between the two groups. Patients were followed-up for 6 months and were evaluated for effectiveness and recurrence. Results Overall effectiveness was similar between the two groups（P 〉 0.05）. Time to wound healing and duration of hospitalization were significantly shorter in the treatment group （P 〈 0.05）. There was no significant difference in duration of operation, amount of blood loss, and duration of perianal edema between the two groups （P 〉 0.05）. Patients in the treatment group had significantly lower pain and were significantly less likely to have difficulties in urination than patients in the control group （P 〈 0.05）. Incidence of incision infection was similar between the two groups （P 〉 0.05）. At follow-up of 6 months, there was no recurrence and all patients were healed with good defecation function. Conclusion There is favorable effect of modified longitudinal incision and transverse suture internal sphincterotomy in treating anal fissure. Compared with open internal sphincterotomy, it is beneficial in reducing postoperative pain and urination difficulties and promoting recovery.

关 键 词：肛裂 改良后纵切横缝内括约肌切断术 临床效果 

分 类 号：R657.1[医药卫生—外科学]