内括约肌侧后位钳夹松解术与内括约肌后位松解术治疗慢性肛裂的临床对比观察

发布时间：2018-10-09 16:13

【摘要】：目的：寻求一种创伤小、疗程短、术后并发症少、安全有效、操作简单的治疗慢性肛裂的手术方法。方法：收集成都中医药大学附属医院肛肠科2013年10月～2014年10月60例慢性肛裂患者。按照随机、对照的原则,将60例患者按照就诊先后顺序标号,通过随机数字表法分为观察组和对照组2组,每组各30例,其中观察组采用内括约肌侧后位钳夹松解术,对照组采用内括约肌后位松解术。观察并记录两组患者术后疼痛情况(术后当天肛门疼痛持续时间、第一次换药肛门疼痛程度、第一次排便时肛门疼痛程度)、术后排尿困难情况、术后出血情况、术后感染情况、术后肛门功能评价、切口愈合时间、住院时间以及术后复发情况,将两组观察结果应用SPSS19.0软件进行统计分析。结果：观察组在减轻术后肛门疼痛程度、减少术后排尿困难及术后出血、缩短切口愈合时间等方面(P0.05)优于对照组；在术后当天肛门疼痛持续时间、术后感染、术后肛门功能、住院时间及术后复发等方面(P0.05)两组间无统计学意义；两组的治愈率均为100%,且均无不良反应发生,差异无统计学意义(P0.05)。结论：内括约肌侧后位钳夹松解术治疗慢性肛裂临床疗效满意,尤其在缩短切口愈合时间、减少术后并发症等方面具有优势,且创伤小、操作简单、安全有效,值得在临床上推广应用。
[Abstract]:Objective: to find a safe and effective method for the treatment of chronic anal fissure with less trauma, shorter course of treatment, less postoperative complications. Methods: from October 2013 to October 2014, 60 patients with chronic anal fissure were collected. According to the principle of randomness and control, 60 patients were divided into observation group and control group with 30 cases in each group by random digit table method. The observation group was treated with internal sphincter lateral and posterior position clamp release. The control group was treated with posterior release of internal sphincter. To observe and record the postoperative pain (the duration of postoperative anal pain, the degree of anal pain at the first time of dressing change, the degree of anal pain during the first defecation), the difficulty of urination after operation, the bleeding after operation and the infection after operation. Postoperative anal function evaluation, incision healing time, hospital stay and postoperative recurrence were analyzed by SPSS19.0 software. Results: the observation group was superior to the control group in reducing the degree of postoperative anal pain, reducing postoperative dysuria and bleeding, shortening the healing time of incision (P0.05), the duration of postoperative anal pain, postoperative infection, postoperative anal function, and so on. There was no significant difference between the two groups in terms of hospitalization time and postoperative recurrence (P0.05); the cure rate of the two groups was 100 and there were no adverse reactions. The difference was not statistically significant (P0.05). Conclusion: the treatment of chronic anal fissure with lateral and posterior internal sphincter clamp release is satisfactory, especially in shortening the healing time of incision and reducing postoperative complications, and has the advantages of small trauma, simple operation, safe and effective. It is worth popularizing in clinic.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.1

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