A型肉毒素内括约肌注联合小切口切扩引流术治疗Ⅱ Ⅲ期肛裂的临床疗效观察

Botulinum Toxin Type A Internal Intramuscular Combined with Mini-incision Drainage in Treating Stage Ⅱ and Ⅲ Anal Fissure

目的:观察A型肉毒素内括约肌注联合小切口切扩引流术治疗Ⅱ、Ⅲ期肛裂的疗效及安全性。方法:选取90例Ⅱ、Ⅲ期肛裂患者按照随机数字表法随机分为治疗组60例与对照组30例,治疗组给予A型肉毒素内括约肌注联合小切口切扩引流术,对照组给予传统肛裂切除术联合肛管内括约肌切断术,比较两组患者疗效指标及并发症情况。结果:治疗组治愈率(95.0%)明显高于对照组(83.3%),手术时间及切口愈合时间明显短于对照组(P<0.05),愈合后瘢痕面积明显小于对照组(P<0.05),术后并发症发生率(1.6%)远低于对照组(13.2%),术后24h疼痛评分也明显低于对照组(P<0.05)。结论:A型肉毒素内括约肌注联合小切口切扩引流术治疗Ⅱ、Ⅲ期肛裂较传统手术效果理想,且具有术后恢复快、疼痛轻、并发症少等优点。

Objective： To observe the efficacy and safety of botulinum toxin type A internal intramuscu- lar combined with mini-incision drainage in treating stage II and III anal fissure. Method： 90 cases with stage II and III anal fissure were selected and divided into two groups randomLy, the treatment group for 60 cases and the control group for 30 cases. The treatment group was treated with botulinum toxin type A internal intramuscular combined with mini-incision drainage, and the control group was treated with traditional exci- sion of anal fissure and ana/ canal sphincter amputation. The efficacy and complications of two groups were compared. Result： The cure rate of the treatment group （95.0% ） was evidently higher than that of the control group （83.3%）, the operation time and incision healing time of the treatment group was evidently shorter than that of the control group（ P〈0.05）, and the scar area after healing was evidently smaller than that of the control group（ P〈0.05） , the incidence rate of complications after operation （ 1.6%） was lower than that of the control group（ 13.2% ） , and the pain score 24h after operation was evidently lower than that of the control group（ P〈0.05 ）. Conclusion： Compared with traditional operation, botulinum toxin type A internal intra- muscular combined with mini-incision drainage in treating stage II and III anal fissure not only has ideal effect, but also has the advantages of rapid recovery after operation, little pain and fewer comolications.