肛裂次侧切术在陈旧肛裂中的运用总结.docVIP

次侧方内括约肌切开加双缘结扎术治疗Ⅲ期肛裂150例临床观察 肖秋平 黄卫平1 林金荣 李庚 （福建中医药大学附属厦门中医院肛肠科） 摘要： 目的 观察次侧方内括约肌切开加双缘结扎术治疗Ⅲ期肛裂临床疗效及其对肛门功能的影响。 方法 治疗组选取Ⅲ期肛裂患者150例，均采用次侧方内括约肌切开加双缘结扎术治疗，观察创口愈合时间、随访6月的复发率及测定手术前后肛门直肠压力，并与健康对照组比较。 结果 所有患者均痊愈出院，创口平均愈合时间（16+2.87）d，随访6个月无复发病例；术前肛管静息压较正常人显著升高(P0.05),肛管舒张压较前显著降低(P0.05)，肛管最大收缩压及肛管自主收缩持续时间与正常人比较无明显差异（P0.05）；术后肛管静息压较术前明显降低(P0.05),肛管舒张压较前明显升高(P0.05)，肛管最大收缩压及肛管自主收缩持续时间与术前比较无明显差异（P0.05）；术后肛管静息压、肛管舒张压、肛管最大收缩压及肛管自主收缩持续时间与正常人比较无明显差异（P0.05）。结论 次侧方内括约肌切开加双缘结扎术治疗Ⅲ期肛裂疗效显著，能有效地解除内括约肌痉挛, 改善肛裂溃疡面的供血不足，促进肛裂的愈合。Clinical observation of Lateral Sub-incision of Internal Sphincter Plus Ligation of Both Borders in The Treatment of 150 patients with Stage Ⅲ Anal Fissure XIAO Qiu-ping,Huang Wei-ping ,Lin Jin-rong,Li Geng Xiamen Hospital of T. C. M，Affiliated Fujian university of traditional chinese medicine Abstract:Objective To observe the efficacy of Lateral Sub-incision of Internal Sphincter Plus Ligation of Both Borders in the treatment of Stage Ⅲ Anal Fissure.Methods 150 patients with Stage Ⅲ Anal Fissure were included into treatment group, They were treated with lateral sub-incision of internal sphincter plus ligation of both borders. Observe the wound healing time and the recurrence rate after 6 months of follow up; Measured the anorectal pressure before and after operation, and compared with the control group of health volunteers.Results All the patients were cured; The average wound healing time was （16+2.87）d,and no recurrence after followed up for 6 months; Compared with normal cases, Preoperative anal resting pressure s after 6 months of follow up (P 0.05),and Anal resting pressure reduced significantly (P0.05),and there was no obvious differences (P 0.05)about preoperative maximal anal contraction pressure and anal voluntary contraction duration; Postoperative anal resting pressure decreased obviously compared with preoperation (P 0.05),and anal diastolic pressure increased significantly (P 0.05), there was no obvious difference about maximal anal contrac