肛门后正中切扩+肛窦切开引流术治疗慢性肛裂的疗效及对创面愈合的影响评价

Evaluation of the therapeutic effect and impact on wound healing of chronic anal fissure treated with posterior midline incision and anal sinus incision and drainage surgery

目的:研究目的在于观察后正中切扩联合窦切开引流术在慢性裂治疗中的效果,以及该治疗方法对创面愈合的影响。方法:选取了66例慢性肛裂患者,随机分配到实验组和对照组,实验组接受肛门后正中切扩联合肛窦切开引流术治疗,对照组接受传统手术治疗。比较两组术后各个时间点疼痛评分、住院时间、创面愈合时间、创面生长因子水平、术后并发症及术后随访6m评估复发情况。结果:术后不同时段疼痛评分比较显示:实验组得分均低于对照组(P<0.05);愈合时间、住院时间比较显示:实验组均短于对照组(P<0.05);实验组术后3d、术后1w创面VEGF、VEGFR-2表达水平比较显示:实验组均高于对照组(P<0.05);实验组并发症发生率(3.03%)、复发率(3.03%)均低于对照组(21.21%、15.15%),差异在统计学上显著(P<0.05)。结论:肛门后正中切扩联合肛窦切开引流术在治疗慢性肛裂方面具有显著的疗效,不仅能有效缓解疼痛,促进创面愈合,同时降低复发率,改善生活质量。该方法为慢性肛裂的临床治疗提供了新的思路和可靠的技术支持,具有广泛的应用前景。

Objective:The purpose of this study is to observe the effect of posterior median incision combined with sinus incision and drainage in the treatment of chronic fissure,and the effect of this treatment on wound healing.Methods:Sixty-six patients with chronic anal fissure were randomly assigned to the experimental group and the control group.The experimental group received posterior median anal incision and expansion combined with anal sinus incision and drainage,while the control group received traditional surgical treatment.The pain score,hospitalization time,wound healing time,wound growth factor level,postoperative complications and postoperative follow-up for 6 months were compared between the two groups to evaluate the recurrence.Results:The comparison of postoperative pain scores at different time points showed that the scores of the experimental group were lower than those of the control group(P<0.05).The comparison of healing time and hospitalization time showed that the experimental group was shorter than the control group(P<0.05).The expression levels of VEGF and VEGFR-2 in the experimental group were higher than those in the control group(P<0.05).The incidence of complications(3.03%)and recurrence rate(3.03%)in the experimental group were lower than those in the control group(21.21%and 15.15%),and the difference was statistically significant(P<0.05).Conclusion:Posterior median anal incision combined with anal sinus incision and drainage has a significant effect in the treatment of chronic anal fissure,which can not only effectively relieve pain,promote wound healing,but also reduce the recurrence rate and improve the quality of life.This method provides a new idea and reliable technical support for the clinical treatment of chronic anal fissure,and has a wide application prospect.