闭式内括约肌离断、病灶切除治疗慢性肛裂的临床研究-中医外科专业论文.docxVIP

成都中医药大学硕士论文 成都中医药大学硕士论文 PAGE PAGE 1 中文摘要 目的：观察和评价闭式内括约肌离断、病灶切除治疗慢性肛裂的 临床疗效。 方法：将 84 例慢性肛裂患者随机分成观察组和对照组，其中观 察组 42 例采用闭式内括约肌离断、病灶切除术，对照组 42 例采用后 正中肛裂切除内括约肌松解术。观察比较两组病例的治愈率、创面愈 合时间、术后并发症及后遗症。 结果：观察组在创面愈合时间、肛门控制功能和肛门锁洞畸形方 面明显优于对照组，且有显著性差异（P﹤0.05）。 结论：闭式内括约肌离断、病灶切除术与后正中肛裂切除内括约 肌松解术相比，具有创口小、创面愈合时间短、更有利于保护肛门功 能的优点。 关键词：闭式；内括约肌离断；病灶切除；临床研究 Abstract Objective: Observe and appraise pairs of side of closing type IAS cut, expand, add anal fissure excise skill treat clinical curative effect of chronic anal fissure. Methods: Divide 84 chronic anal fissure patient into observe group and control group at random, and two groups of case are counted equally, observe 42 of group adopt pairs of side of closing type IAS cut, expand, add anal fissure excise skill among them, loose solving skill of the IAS in anal fissure in the centre is excised after 42 control groups adopt. Observe cure rate, wound surface of comparing two groups of case and heal time, postoperative complication and sequela. Result: Observe the group in the wound surface heal time, rectum to control function and rectum and lock the odd-shaped respect of hole is obviously superior to the control group, and there is significance difference (P0.05). Conclusion: Pairs of side of closing type IAS cut, expand, add anal fissure excise skill with after while excising IAS solving skills loose compare centre anal fissure, have wounds little, the wound surface heals time is short, furthermore helps to protect the rectum function advantage. Keywords: Closing type; The IAS is cut and expanded in pairs of side; Anal fissure is excised; Clinical research 28 28 申明 硕士学位论文闭式内括约肌离断、病灶切除治疗慢性肛裂的 临床研究是本人在成都中医药大学攻读硕士学位期间在导师指导下 完成的，该论文成果归成都中医药大学所有。有关学位论文成果的开 发、转让、论文发表等，均需征得导师和成都中医药大学同意。 硕士生签名： 导 师 签 名： 年 月 日 PAGE PAGE 10 闭式内括约肌离断、病灶切除治疗慢性肛裂 的临床研究 引言 肛裂是肛管皮肤发生纵行全层裂开，深达肌层，形成梭形溃疡， 引起排便性周期性肛门剧烈疼痛者。其发病率仅次于痔疮，在肛门大 肠疾病中约占 20﹪，是肛门直肠疾病中占第二位的常见病。肛裂好 发于中青年，以 20—40 岁多见，老人和儿童少见。肛裂的发生与肛 管的解剖缺陷、饮食、大便干结和排便时过度用力等因素相关。慢性 肛裂是由于肛管的扩张和约束力之间的平衡失调，导致肛管皮肤裂 伤，并在