肛裂切除并侧方内括约肌切断术治疗慢性肛裂的效果分析

The effect analysis of anal fissure resection combined with internal sphincterotomy forchronic anal fissure

目的探讨肛裂切除并内括约肌切断术治疗慢性肛裂的临床疗效。方法纳入120例慢性肛裂患者作为研究对象,随机分为两组,每组各60例。观察组行肛裂原位切除并侧方内括约肌切断术,对照组行后正中切开扩创术。比较两组治疗效果、术后并发症及康复情况。结果观察组治疗总有效率为98.33%,对照组为95%,组间比较无显著性差异(P>0.05)。观察组术后肛门溢液和并发症总发生率分别发生率为1.67%和13.33%,均显著低于对照组(均P<0.05)。观察组术后肛门功能恢复时间及切口愈合时间分别为(6.76±1.37)d及(8.06±2.51)d,均显著低于对照组(均P<0.05)。结论肛裂切除并侧方内括约肌切断术与后正中切开扩创术用于慢性肛裂疗效相当,前者能显著缩短术后康复时间,且安全性更高。

Objective To study the clinical curative effect of anal fissure excision and internal sphincterotomy for chronic anal fissure.Methods 120 patients with chronic anal fissure were randomly assigned into two groups,with 60 cases in each group. The treatment group underwent orthotopic anal fissure excision and lateral internal sphincterotomy,and the control group underwent posterior median incision debridement. The therapeutic effects,postoperative complications and rehabilitation of the two groups were compared. Results The total effective rate in the treatment group was 98.33%,and in the control group 95%,with no significant difference between the two groups（P〉0. 05）. The incidence of anal overflow and complication rate in the treatment group were 1.67% and 13.33%,respectively,which were significantly lower than that in the control group（P〈0. 05）. The incidence of recovery time of anal function and incision healing time in observation group were [（6.76±1.37） d and（8.06±2.51） d],respectively,which were significantly lower than those in control group（P〈0. 05）. Conclusion The orthotopic anal fissure excision combined with lateral internal sphincterotomy and posterior median incision debridement has similar effect in the treatment of chronic anal fissure,but the former can significantly shorten the postoperative recovery time,with better safety.