肛裂次侧切术在陈旧肛裂中的运用总结.doc

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1、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(P<0.05),肛管舒张压较前显著降低(P<0.05)，肛管最大收缩压及肛管自主收缩持续时间与正

2、常人比较无明显差异（P>0.05）；术后肛管静息压较术前明显降低(P<0.05),肛管舒张压较前明显升高(P<0.05)，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（P>0.05）；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（P>0.05）。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。关键词：肛裂；次侧切术；双缘结扎术；肛管直肠压力测定ClinicalobservationofLateralSub-incisionofInternalS

3、phincterPlusLigationofBothBordersinTheTreatmentof150patientswithStageⅢAnalFissureXIAOQiu-ping,HuangWei-ping,LinJin-rong,LiGengXiamenHospitalofT.C.M，AffiliatedhospitaltoFujianuniversityoftraditionalchinesemedicineAbstract:ObjectiveToobservetheefficacyofLateralSub-incisionofInternalSphincte

4、rPlusLigationofBothBordersinthetreatmentofStageⅢAnalFissure.Methods150patientswithStageⅢAnalFissurewereincludedintotreatmentgroup,Theyweretreatedwithlateralsub-incisionofinternalsphincterplusligationofbothborders.Observethewoundhealingtimeandtherecurrencerateafter6monthsoffollowup;Measure

5、dtheanorectalpressurebeforeandafteroperation,andcomparedwiththecontrolgroupofhealthvolunteers.ResultsAllthepatientswerecured;Theaveragewoundhealingtimewas（16+2.87）d,andnorecurrenceafterfollowedupfor6months;Comparedwithnormalcases,Preoperativeanalrestingpressuresafter6monthsoffollowup(P<0.

6、05),andAnalrestingpressurereducedsignificantly(P<0.05),andtherewasnoobviousdifferences(P>0.05)aboutpreoperativemaximalanalcontractionpressureandanalvoluntarycontractionduration;Postoperativeanalrestingpressuredecreasedobviouslycomparedwithpreoperation(P<0.05),andanaldiastolicpressureincre

7、asedsignificantly(P<0.05),therewasnoobviousdifferenceaboutmaximalanalcontractionpressureandanalvoluntarycontractiondurationbfforeandafteroperation(P>0.05);Therewasnoobviousdifferences(P>0.05)aboutpostoperativeanalrestingpressure,anadiastolicpressure,maximalanalcontr