摘要
目的比较肛裂切除结合内括约肌后正方位与侧方位切断术治疗慢性肛裂的临床疗效。方法选取2015年4月至2017年6月深圳市龙华区人民医院收治的慢性肛裂患者90例为研究对象,采用随机数字法分为观察组和对照组,各45例。观察组行肛裂切除结合内括约肌侧方位切断术,对照组行肛裂切除结合内括约肌后正方位切断术。观察两组患者的临床疗效、手术及术后相关指标以及术后并发症发生率。结果两组患者临床疗效比较差异无统计学意义(P>0.05)。观察组术中出血量少于对照组[(24.13±4.89)m L比(28.52±4.94)m L],术后48 h疼痛评分低于对照组[(4.13±0.46)分比(5.02±0.69)分],肛门功能恢复时间及切口愈合时间短于对照组[(7.44±1.71)d比(9.47±1.98)d,(8.98±1.53)d比(11.18±2.06)d](P<0.01)。观察组并发症发生率低于对照组[8.89%(4/45)比24.44%(11/45)](P<0.05)。结论肛裂切除结合内括约肌侧方位与后正方位切断术治疗慢性肛裂均有确切效果,但前者可减少术中出血,促进术后恢复,安全性更高。
Objective To compare the clinical effect of anal fissure excision combined with posterior internal sphincter cut and lateral internal sphincter cut for chronic anal fissure. Methods A total of 90 patients with chronic anal fissure treated in Shenzhen Longhua District People＇s Hospital from Apr. 2015 to Jun. 2017 were included in the study, and were divided into an observation group of 45 cases and a control group of 45 cases by the random number method. The observation group underwent anal fissure resection combined with posterior internal sphincter cut,while the control group were underwent anal fissure excision combined with lateral internal sphincter cut. The clinical effect, the operative and postoperative related indicators and postoperative complications of the two groups were observed. Results There was no significant difference in clinical efficacy between the two groups （ P 〉 0.05 ）. The amount of intraoperative bleeding in the observation group was lower than that in the control group [ （24.13 ±4.89） mL vs （28.52 ±4.94） roll ,the pain score at 48 hours after opera- tion was lower than that in the control group [ （4.13 ± 0.46 ） scores vs （5.02 ±0.69 ） scores ], the recovery time of anal function and the wound healing time were shorter than those in the control group [ （7.44 ±1.71 ） d vs （9.47 ± 1.98） d, （8.98 ± 1.53 ） d vs （ 11.18 ± 2.06 ） d] （ P 〈 0.01 ）. The incidence of complications in the observation group was lower than that in the control group [ 8.89% （4/45） vs 24.44% （ 11/45 ） 1 （ P 〈 0.05 ）. Conclusion The anal fissure excision combined with lateral internal sphincter cut and posterior internal sphincter cut in treatment of chronic anal fissure both have exact effect, but the former can reduce the intraoperative bleeding, promote postoperative recovery,with higher safety.
作者
曾成永
曹传敏
刘家荣
苏松盛
何进达
ZENG Chengyong;CAO Chuanmin;LIU Jiarong;SU Songsheng;HE Jinda(Department of Anoreetal Surgery,Longhua District People＇s Hospital,Shenzhen 518109,China)
出处
《医学综述》
2018年第19期3919-3922,共4页
Medical Recapitulate
关键词
慢性肛裂
肛裂切除
内括约肌切断
后正方位
侧方位
Chronic anal fissure
Anal fissure resection
Internal sphincter cut
Posterior
Lateral
