小针刀治疗肛裂的临床研究

The clinical study of lateral internal sphincterotomy by small needle scalpel for the treatment of anal fissure

目的通过随机对照研究,比较小针刀侧方内括约肌切断术和后方内括约肌切断术对肛裂治疗的疗效和安全性。方法观察96例肛裂患者,其中48例采用小针刀侧方内括约肌切断术(观察组),48例采用后方内括约肌切断术(对照组),比较两组疗效、术后疼痛评分、术后并发症、恢复正常生活时间、伤口愈合时间、伤口愈合等级和术后1年复发率。结果 2组患者疗效和术后1年复发率相近,而观察组在恢复正常生活时间、伤口愈合时间和伤口愈合等级方面明显优于对照组,且术后疼痛、尿潴留、出血、大便失禁、肛周感染等并发症发生率相对较少。结论小针刀侧方内括约肌切断术治疗肛裂具有安全、有效、创伤小、恢复快、并发症发生率低等优点。

Objective The safety and effectiveness of the lateral internal sphincterotomy by small needle scalpel and the posterior midline internal sphincterotomy for the treatment of anal fissure were compared in this randomized controlled study.Methods Ninety-six cases with the diagnosed of anal fissure were analyzed during June 2006 to June 2009 in our hospital.Patients were divided into two groups：48 cases in the observation group （with the lateral internal sphincterotomy using small needle scalpel） and 48 cases in the control group （with the posterior midline internal sphincterotomy）.The efficacy of the two groups,postoperative pain score,postoperative complications,recovery time to normal life,the time of wound healing,the grade of wound healing and the rate of recurrence after 1 year were compared.Results After treatment,the efficacy and the rate of recurrence after 1 year was similar In the two groups.The observation group was obviously better than the control group in the recovery time to normal life,the time of wound healing and the grade of wound healing;moreover,the incidence of complications such as postoperative pain,urinary retention,bleeding,fecal incontinence and perianal infection was lowerin the treatment group than those of the control group.Conclusion The lateral internal sphincterotomy by small needle scalpel has lots of advantages,such as safety,effectiveness,less invasive,quick recovery and low incidence of complications,so it is worthy of extended usage.