摘要
目的评价经括约肌间入路的闭式内括约肌侧切术治疗陈旧性肛裂的临床效果及发病特征。方法选取2020年1月至12月上海中医药大学附属龙华医院肛肠科收治的83例陈旧性肛裂患者,根据手术方式将其分为治疗组(34例)和对照组(49例)。治疗组采用经括约肌间入路的闭式内括约肌侧切术,对照组采用肛裂切扩术,分析两组临床效果、愈合时间、术后第3天的疼痛和出血情况、术中出血量、手术时间、住院费用、住院时间、出院后3个月的肛门功能异常复发情况,总结陈旧性肛裂的发病特征。结果本研究结果显示,陈旧性肛裂多为单个裂口,裂口主要位于6点位,临床症状多为疼痛和出血,并发症多为哨兵痔。两组治愈率均为100%,术后3个月均无肛门功能异常及复发。两组术中出血、住院费用、住院时间比较,差异无统计学意义(P>0.05)。治疗组术后第3天疼痛及出血情况轻于对照组,愈合时间短于对照组,手术时间长于对照组,差异有统计学意义(P<0.05)。结论经括约肌间入路的闭式内括约肌侧切术治疗陈旧性肛裂患者效果确切,可以加速术后康复,值得应用推广。
Objective To evaluate the clinical effect of closed internal sphincter sphincterotomy through intersphincter approach for the treatment of old anal fissure and its pathogenic characteristics.Methods Eighty-three patients with old anal fissure admitted to the Department of Anorectal,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January to December 2020 were selected and divided into treatment group(34 cases)and control group(49 cases)according to the surgical methods.The treatment group was treated with closed internal sphincterotomy through intersphincteric approach,while the control group was treated with anal fissure incision and expansion.The clinical effect,healing time,pain and bleeding at the third day after surgery,intraoperative blood loss,operation time,hospitalization cost,hospitalization time,and abnormal anal function and recurrence at three months after discharge of the two groups were analyzed,and the pathogenic characteristics of old anal fissure were summarized.Results The results of this study showed that most of the old anal fissure consisted of single fissure,which was mainly located at the six o’clock position.Most of the clinical symptoms were pain and bleeding,and most of the complications were sentinel hemorrhoids.Both groups were cured,and there was no abnormal anal function or recurrence at three months after operation.There were no significant differences in intraoperative blood lose,hospitalization cost,and hospitalization time between the two groups(P>0.05).The pain and bleeding at the third day after surgery in the treatment group were less than those in the control group,the healing time was shorter than that in the control group,and the operation time was longer than that in the control group,the differences were statistically significant(P<0.05).Conclusion Closed internal sphincterotomy through intersphincter approach for the treatment of patients with old anal fissure is effective,can accelerate postoperative rehabilitation,worthy of app
作者
秦钦
董青军
王琛
QIN Qin;DONG Qingjun;WANG Chen(Institute of Traditional Chinese Medicine Surgery,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai200032,China;Department of Anorectal,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai200032,China)
出处
《中国医药导报》
CAS
2023年第13期92-95,共4页
China Medical Herald
基金
国家自然科学基金资助项目(82074441)
上海市科学技术委员会科研计划项目(19401933000)
浙江省宁波市医学科技计划项目(2020Y37)。
关键词
陈旧性肛裂
发病特征
括约肌间入路
闭式内括约肌侧切术
Chronic anal fissure
Pathogenic characteristics
Intersphincter approach
Closed lateral internal sphincterotomy
