A型肉毒素治疗慢性肛裂的疗效及安全性观察

Treatment of Chronic Anal Fissure with Botulinum Toxin A

目的探讨局部注射A型肉毒素治疗慢性肛裂的有效性和安全性。方法于前正中线两侧的肛门内括约肌处注射A型肉毒素30 U治疗40例慢性肛裂患者,观察其临床疗效和不良反应。结果治疗后4周,有26例患者痊愈,7例患者好转,7例患者未愈,2例患者出现短期轻度大便失禁,表现为对气体的控制能力丧失,但均在肉毒素注射后3周内自行缓解;治疗后8周,有31例患者痊愈,2例患者好转,7例患者未愈,8周时总痊愈率77.5%。随访1年,31例痊愈患者中有3例复发,均经再次注射肉毒素后痊愈。结论局部注射肉毒素是治疗慢性肛裂的一种有效的非手术方法,操作简单、安全。

Objective To evaluate the effectiveness and safety of botulinum toxin A injection in treatment of chronic anal fissure. Methods Forty patients with chronic anal fissure were treated with botulinum toxin A （30units） injected into internal anal sphincter. Cure rates and side effects were recorded during treatment. Results Four weeks after treatment, 26 patients （65%） were cured, 7 patients had symptomatic improvement, two patients had mild incontinence to flatus which remitted spontaneously within 3 weeks after treatment. Eight weeks after treatment, 31 patients （77.5%） were cured of fissures, 2 patients had symptomatic improvement. Three patients relapsed during 12 months of follow -up, but all healed when re -treated with botulinum toxin A. Conclusion Botulinum toxin A injection is a safe and effective nonsurgical method in treatment of chromic anal fissure.