肛门后位内括约肌侧切术在慢性肛裂中的疗效及对机体应激的影响观察  

Observation on the Effect of Lateral Incision with Anus Posterior Internal Sphincter in the Patients with Chronic anal Fissure and Influence for Body Stress

作　　者：郑富强 梁澄照 彭隽晖 ZHENG Fuqiang;LIANG Chengzhao;PENG Juanhui(Guangzhou University of Chinese Medicine Shunde Hospital,Foshan 528300,China;不详)

机构地区：[1]广州中医药大学顺德医院,广东佛山528300

出　　处：《中国医学创新》2021年第17期155-158,共4页Medical Innovation of China

基　　金：2020年佛山市自筹经费类科技计划项目(医学类科技攻关)(2020001004551)。

摘　　要：目的:探究肛门后位内括约肌侧切术在慢性肛裂中的疗效及对机体应激的影响。方法:选取2018年10月-2020年12月的80例慢性肛裂患者为研究对象,将其根据手术方式的不同分为对照组和观察组,每组40例。对照组采用内括约肌正位切除术治疗,观察组采用肛门后位内括约肌侧切术治疗。比较两组的临床疗效,比较两组手术前后的创缘水肿程度、疼痛程度及机体应激指标(炎性应激指标与应激激素指标)。结果:观察组的临床总有效率显著高于对照组,差异有统计学意义(P<0.05)。术前,两组的创缘水肿程度、疼痛程度比较,差异均无统计学意义(P>0.05);术后1、3、5 d,观察组的创缘水肿程度、疼痛程度均轻于对照组,差异均有统计学意义(P<0.05)。术前,两组的炎性应激指标、应激激素指标比较,差异均无统计学意义(P>0.05);术后1、3、5 d,观察组的IL-6、TNF-α、Cor、ALD水平均显著低于对照组,差异均有统计学意义(P<0.05)。结论:肛门后位内括约肌侧切术在慢性肛裂中的疗效较好,且可显著改善机体应激反应,因此在慢性肛裂患者中的应用价值较高。Objective:To investigate the effect of lateral incision with anus posterior internal sphincter in the patients with chronic anal fissure and influence for body stress.Method:A total of 80 patients with chronic anal fissure from October 2018 to December 2020 were selected as the research objects.The patients were divided into control group and observation group according to different surgical methods,40 cases in each group.The control group was treated with internal sphincter resection,and the observation group was treated with lateral incision with anus posterior internal sphincter.Clinical efficacy of the two groups was compared,and the degree of edema,pain and body stress indexes(inflammatory stress indexes and stress hormone indexes)before and after surgery were compared between the two groups.Result:The total clinical effective rate of the observation group was significantly higher than that of the control group,the difference was statistically significant(P<0.05).Before surgery,there were no significant differences in edema degree and pain degree between the two groups(P>0.05);on day 1,3 and 5 after surgery,edema and pain of the wound edge in the observation group were less than those in the control group,the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in the inflammatory stress index and stress hormone index between the two groups(P>0.05);on day 1,3 and 5 after surgery,the levels of IL-6,TNF-α,COR and ALD in observation group were significantly lower than those in control group,the differences were statistically significant(P<0.05).Conclusion:The effect of lateral incision with anus posterior internal sphincter in the patients with chronic anal fissure is better,and it can significantly improve the body stress response,so its application value in the patients with chronic anal fissure is higher.

关 键 词：肛门后位内括约肌侧切术 慢性肛裂 机体应激 

分 类 号：R657.14[医药卫生—外科学]