微型切口内括约肌松解术联合龙珠软膏治疗慢性肛裂临床疗效观察  

Clinical Observation of Microincision Internal Sphincter Release Combined with Dragon Ball Ointment in the Treatment of Chronic Anal Fissur

作　　者：涂艳琴 余绪超 丁逸矾 章钰川 肖慧荣[2] TU Yan-qin;YU Xu-chao;DING Yi-fan;ZHANG Yu-chuan;XIAO Hui-rong(12021 Graduate Student,Clinical Medicine School,Jiangxi University of Traditional Chinese Medicine,Nanchang 330004;Department of Anorectal,Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Nanchang 330006)

机构地区：[1]江西中医药大学临床医学院,南昌330004 [2]江西中医药大学附属医院肛肠科,南昌330006

出　　处：《实用中西医结合临床》2023年第9期1-4,14,共5页Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine

基　　金：江西省卫生健康委科技计划项目(编号:SKJP220227451)。

摘　　要：目的:探讨微型切口内括约肌松解术联合龙珠软膏治疗慢性肛裂的安全性及可行性。方法:选取江西中医药大学附属医院肛肠科2020年1月至2022年1月收治的慢性肛裂患者100例,按随机数字表法分为观察组50例(微型切口内括约肌松解术联合龙珠软膏治疗)与对照组50例(开放式内括约肌切断术联合龙珠软膏治疗)。比较两组术中出血量、手术用时、术后首次排便出血量,术前及术后1 d、7 d、14 d视觉模拟评分(VAS),术后24 h排尿情况、创面愈合时间、术后创面感染情况、术后肛门外观评分、术后肛门失禁及复发情况。结果:治疗后观察组术中出血量、手术用时及术后首次排便出血量、创面愈合时间、术后肛门外观评分均显著优于对照组,差异有统计学意义(P<0.05);治疗后观察组VAS评分低于对照组,差异有统计学意义(P<0.05);两组临床疗效、术后24 h排尿情况、并发症发生率及复发率比较,差异无统计学意义(P>0.05)。结论:微型切口内括约肌松解术联合龙珠软膏治疗慢性肛裂,术后效果显著,明显改善术后疼痛感,缩短创面恢复时间,安全性较高,且能更好地保护肛门外观及功能。Objective:To investigate the safety and feasibility of microincision internal sphincter release combined with dragon ball ointment in the treatment of chronic anal fissure.Methods:A total of 100 patients were selected from the Anorectal Department of Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from January 2020 to January 2022.50 cases were divided into observation group(microincision internal sphincter release combined with dragon ball ointment)and control group(open internal sphincterotomy combined with dragon ball ointment)by random number table method.The amount of intraoperative blood loss,operation time,bleeding after the first defecation,visual analogue scale(VAS)before and after the operation at 1 day,7 day and 14 day,postoperative 24-hour urination status,wound healing time,postoperative wound infection,postoperative anal appearance score,postoperative anal incontinence and recurrence rate of the two groups were observed and compared.Results:After treatment,intraoperative blood loss,operation time,first postoperative defecation bleeding,wound healing time and postoperative anal appearance scores in the observation group were significantly lower than those in the control group,with statistical significances(P<0.05).VAS score of the observation group was lower than that of the control group after treatment,and the difference was statistically significant(P<0.05).There was no significant difference in clinical efficacy,postoperative 24-hour urination status,the incidence of complications and recurrence rate (P>0.05). Conclusion: Microincision internal sphincter release combined with dragon ball ointment in the treatment of chronic anal fissure has significant postoperative effects, which can significantly improve postoperative pain, shorten the incision recovery time, have high safety, and can better protect the appearance and function of the anus.

关 键 词：慢性肛裂 微型切口内括约肌松解术 开放式内括约肌切断术 龙珠软膏 创面愈合时间 

分 类 号：R266[医药卫生—中医外科学]