改良肛管扩张术治疗肛管狭窄应用探讨——附2373例报告

Discussion on improved anal canal dilation operation in the treatment of anal canal stricture

目的:探讨改良肛管扩张术治疗肛管狭窄的疗效。方法:对2373例肛管狭窄患者行改良肛管扩张术——肛管外括约肌肌筋膜增厚带部分切除松解术,观察患者术后疗效。结果:手术时间30～55min,中位时间41min;术程顺利2340例,术中出血量较多33例,给予相应的止血处理后均能顺利完成手术。随访10～12个月,2291例患者均治愈,再发肛管狭窄8例(0.34%),经再次手术后治愈;肛门皮肤皲裂74例(3.12%),采用局部外涂氧化锌软膏后均治愈。结论:改良后肛管扩张术治疗肛管狭窄手术简单、出血较少、并发症发生率低,值得临床酌情选用。

Objective： To investigate the curative effect of improved anal canal dilation operation for anal canal stricture. Methods： 2 373 cases of anal canal stricture were cured by improved anal canal dilation operation partial ablation and lysis of the thickening anal canal external sphincter muscular fasciae. The curative effect of the operation was observed. Results： The operation time was 30 -55 mins, the media time was 41 mins. The processes of operation were smooth in 2 340 cases. Despite increased loss blood were found in 33 cases, the operation could be finished smoothly after supplying haemostasis. After 10 -12 months of follow-up visit, 2 291 cases were cured, 8 cases （0. 34% ） relapsed and were cured after the second operation. 74 cases （ 3.12% ） with chapped skin of anus were cured after applying unguentum zinci oxidi partly. Conclusion： Improved anal canal dilation operation is simple, safe with less loss of blood and has low incidence rate of complication, and worth of applying in clinical practice.