肛裂切除带状皮瓣推移术对陈旧性肛裂患者肛门功能的影响
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摘要
目的探究肛裂切除带状皮瓣推移术对陈旧性肛裂患者肛门功能的影响。方法收集我院2017年5月—2018年9月间收治的120例陈旧性肛裂患者资料,按随机数字法将其分为对照组(58例)和研究组(62例),对照组患者接受侧方内括约肌切开术治疗,研究组患者接受肛裂切除带状皮瓣推移术治疗。比较两组临床指标、肛门功能及并发症情况。结果研究组创面愈合时间、住院时间低于对照组,而手术时间高于对照组(P<0.05);与术前相比,术后1周、术后1月、术后半年,两组Wexner评分均出现下降,且研究组低于对照组(P<0.05);研究组便血、尿潴留、肛门疼痛、肛缘水肿、创口感染、肛门失禁等并发症发生率低于对照组(P<0.05)。结论肛裂切除带状皮瓣推移术治疗陈旧性肛裂效果显著,可提高肛门功能,降低并发症,值得临床推广。
Objective To investigate the effect of anal fissure excision bandage flap operation on anal function in patients with old anal fissure. Methods The data of 120 patients with old anal fissure who were admitted to our hospital from May 2017 to September 2018 were collected for retrospective analysis. They were divided into control group(58 cases) and research group(62 cases) according to the random number method. The control group received lateral sphincter incision. The patients in the study group underwent treatment of anal fissure excision bandage flap operation. The clinical indicators, anal function and complications were compared between the two groups. Results The healing time and hospitalization time of the study group were lower than that of the control group, and the operation time was higher than that of the control group(P<0.05). Compared with the preoperative period, 1 week after surgery, 1 month after surgery, and half a year after surgery, the Wexner scores of the two groups showed a significant decrease, and the study group was lower than the control group(P<0.05). The incidence of complications such as blood in the stool, urinary retention, anal pain, anal edema, wound infection and anal incontinence were lower in the study group than in the control group(P<0.05). Conclusion Anal fissure excision bandage flap operation for the treatment of old anal fissure is effective, which may improve anal function and reduce complications. It is worthy of clinical promotion.
Objective To investigate the effect of anal fissure excision bandage flap operation on anal function in patients with old anal fissure. Methods The data of 120 patients with old anal fissure who were admitted to our hospital from May 2017 to September 2018 were collected for retrospective analysis. They were divided into control group(58 cases) and research group(62 cases) according to the random number method. The control group received lateral sphincter incision. The patients in the study group underwent treatment of anal fissure excision bandage flap operation. The clinical indicators, anal function and complications were compared between the two groups. Results The healing time and hospitalization time of the study group were lower than that of the control group, and the operation time was higher than that of the control group(P<0.05). Compared with the preoperative period, 1 week after surgery, 1 month after surgery, and half a year after surgery, the Wexner scores of the two groups showed a significant decrease, and the study group was lower than the control group(P<0.05). The incidence of complications such as blood in the stool, urinary retention, anal pain, anal edema, wound infection and anal incontinence were lower in the study group than in the control group(P<0.05). Conclusion Anal fissure excision bandage flap operation for the treatment of old anal fissure is effective, which may improve anal function and reduce complications. It is worthy of clinical promotion.
引文
[1] 陆文强.清热燥湿方熏洗对陈旧性肛裂术后创面愈合及炎症因子水平的影响[J]. 结直肠肛门外科,2018,24(1):64- 67.
[2] 戴秋安,赵金龙,朱建红.内括约肌侧切联合肛周皮瓣移植术治疗32例Ⅲ期肛裂的临床效果观察[J]. 结直肠肛门外科,2018,24(2):149-152.
[3] 美国结直肠外科医师协会,丁义江,皇甫少华,等. 肛裂临床诊治指南(第三次修订) [J]. 中华胃肠外科杂志,2013,16(7):689- 690.
[4] 张立,倪秀茹,徐晨龙,等. 后侧切保留齿线术对陈旧性肛裂患者肛门功能的影响[J]. 结直肠肛门外科,2017,23(5):605- 608.
[5] 詹兴云,闫作斌,刘文全,等. 改良纵切横缝术治疗慢性肛裂的临床疗效观察[J]. 结直肠肛门外科,2017,23(4):494- 497.
[6] 蒋伟冬,殷立新,申早立,等. 肛门内括约肌侧方半切结扎塑型术治疗陈旧性肛裂的临床观察[J]. 上海中医药杂志,2018,52(6):56-58.
[7] 孙长河,胡军.肛裂切除并侧方内括约肌切断术治疗慢性肛裂的效果分析[J]. 结直肠肛门外科,2017,23(3):304-307.
[8] 甘国光.百多邦联合康复新液对低位肛瘘术后患者创面及肛门功能的影响分析[J]. 结直肠肛门外科,2018,24(1):60- 63.
[2] 戴秋安,赵金龙,朱建红.内括约肌侧切联合肛周皮瓣移植术治疗32例Ⅲ期肛裂的临床效果观察[J]. 结直肠肛门外科,2018,24(2):149-152.
[3] 美国结直肠外科医师协会,丁义江,皇甫少华,等. 肛裂临床诊治指南(第三次修订) [J]. 中华胃肠外科杂志,2013,16(7):689- 690.
[4] 张立,倪秀茹,徐晨龙,等. 后侧切保留齿线术对陈旧性肛裂患者肛门功能的影响[J]. 结直肠肛门外科,2017,23(5):605- 608.
[5] 詹兴云,闫作斌,刘文全,等. 改良纵切横缝术治疗慢性肛裂的临床疗效观察[J]. 结直肠肛门外科,2017,23(4):494- 497.
[6] 蒋伟冬,殷立新,申早立,等. 肛门内括约肌侧方半切结扎塑型术治疗陈旧性肛裂的临床观察[J]. 上海中医药杂志,2018,52(6):56-58.
[7] 孙长河,胡军.肛裂切除并侧方内括约肌切断术治疗慢性肛裂的效果分析[J]. 结直肠肛门外科,2017,23(3):304-307.
[8] 甘国光.百多邦联合康复新液对低位肛瘘术后患者创面及肛门功能的影响分析[J]. 结直肠肛门外科,2018,24(1):60- 63.