扩切术和侧切术治疗陈旧性肛裂疗效比较

Comparison on the Therapeutic Effects of Extended Resection Procedure and Lateral Resection Procedure for Chronic Anal Fissure

为探讨陈旧性肛裂术中扩创范围及切断肛门括约肌的合理性，将80例陈旧性肛裂随机分为治疗组和对照组各40例。治疗组采用扩切术，彻底扩创；对照组采用侧切术，简单扩创，两组均取肛门括约肌送病理切片检查。结果显示，80例均切断了内括约肌，其中冶疗组27例，对照组10例切断了部分外括约肌皮下部。治疗组治愈率95％，好转率5％．总有效率100％；对照组治愈率75％，好转率20％，无效5%，总有效率95％。治疗组疗效优于对照组。结果表明，以肛管能容纳4指为标准切断肛门括约肌具有合理性，肛裂扩创是一个不可忽视的环节；后侧位扩切术疗效确切．是治疗陈旧性肛裂的良好术式。

In order to explore the rationality of wound enlargement range and resecting anal sphincter during the operation for chronic fissure authors divided randomly the 80 patients into treatment group and controlled group（40 cases,each group）. Treatment group was subjected to extended resection, throught enlargement of wound; controlled group to lateral resection, simple enlargement of wound. Then the anal sphincters of both group were taken for the pathological examination of section. As results, internal sphincter of the 80 patients was all amputated,among whom 27 patients of treatment group and 10 patients of controlled group underwent amputation of hypodermic partial external sphincter. In treatment group the curative rate, improvement rate and total effective rate was 95%,5 % and 100 %, respectively; while in controlled group was 75%,20% and 95% ,no response rate was 5%. Thus, treatment group was superior to controlled group in the curative effect. Results show that the standard for amputation of anal sphincter which anal canal can accommodate four fingers has rationality,enlargement of wound for anal fissure is an important step,the posterior lateral extended resection has certain therapeutic effect, thus is a better procedure in the treatment of chronic anal fissure.