瘢痕松解术联合纵切横缝术治疗医源性肛门狭窄的临床疗效观察
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摘要
目的观察瘢痕松解术联合纵切横缝术治疗医源性肛门狭窄的临床疗效。方法将2017年5月至2018年5月在江西中医药大学附属医院收治住院的40例医源性肛门狭窄患者,按随机分组法分为两组,各20例。治疗组采用瘢痕松解术联合纵切横缝术治疗,对照组采用瘢痕松解术治疗。观察两组患者治疗前后肛管直径的变化、术后临床疗效、手术切口完全愈合所需时间及术后疼痛情况、术后半年随访情况。运用SPSS17.0统计软件进行分析。结果治疗组治疗有效率为100%,对照组为85%,差异具有统计学意义(P<0.05)。与对照组相比较,治疗组切口完全愈合所需时间更短,治疗前后肛管直径变化更大、术后半年复发率更低。在术后疼痛方面,术后第14天,治疗组VAS疼痛积分明显小于对照组,有显著性差异(P<0.05)。结论瘢痕松解术联合纵切横缝术治疗医源性肛门狭窄,具有更好的临床效果,可明显改善患者术后的疼痛感及明显缩短切口恢复时间,值得在临床上推广使用。
Objective To observe the clinical effect of the treatment of iatrogenic anal stricture by scar release combined with longitudinal and transverse suture. Methods From May 2017 to May 2018, 40 patients with iatrogenic anal stricture admitted in affiliated Hospital of Jiangxi University of traditional Chinese Medicine were randomly divided into treatment group and control group,20 cases in each group. The control group was treated with scar lysis and the treatment group with longitudinal and transverse slit. The changes of anal canal diameter, the clinical effect, the time required for complete healing of surgical incision and the postoperative pain were observed before and after treatment in the two groups. SPSS17.0 statistical software was used to analyze. Results The effective rate of treatment was 100% in the treatment group and 85% in the control group(P<0.05). Compared with the control group, the complete healing time of incision in the treatment group was shorter, the diameter of anal canal changed more before and after treatment,and the recurrence rate was lower half a year after operation. On the 14 th day after operation, the pain score of VAS in the treatment group was significantly lower than that in the control group(P<0.05). Conclusion The treatment of iatrogenic anal stricture with scar release combined with longitudinal and transverse suture has a better clinical effect. It can obviously reduce the pain and shorten the recovery time of incision and reduce the economic burden of the patients. It is worth popularizing in clinic.
Objective To observe the clinical effect of the treatment of iatrogenic anal stricture by scar release combined with longitudinal and transverse suture. Methods From May 2017 to May 2018, 40 patients with iatrogenic anal stricture admitted in affiliated Hospital of Jiangxi University of traditional Chinese Medicine were randomly divided into treatment group and control group,20 cases in each group. The control group was treated with scar lysis and the treatment group with longitudinal and transverse slit. The changes of anal canal diameter, the clinical effect, the time required for complete healing of surgical incision and the postoperative pain were observed before and after treatment in the two groups. SPSS17.0 statistical software was used to analyze. Results The effective rate of treatment was 100% in the treatment group and 85% in the control group(P<0.05). Compared with the control group, the complete healing time of incision in the treatment group was shorter, the diameter of anal canal changed more before and after treatment,and the recurrence rate was lower half a year after operation. On the 14 th day after operation, the pain score of VAS in the treatment group was significantly lower than that in the control group(P<0.05). Conclusion The treatment of iatrogenic anal stricture with scar release combined with longitudinal and transverse suture has a better clinical effect. It can obviously reduce the pain and shorten the recovery time of incision and reduce the economic burden of the patients. It is worth popularizing in clinic.
引文
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[8]贾兰斯,李俊姣,范学顺.肛门狭窄的中西医诊疗研究进展[J].中日友好医院学报,2014,28(05):308-310.
[9]蒋艳,卢雪娇,乔峰妮,等.改良侧方纵切横缝内括约肌切断术治疗肛裂的临床效果观察[J].结直肠肛门外科,2018,24(S1):1-3.
[10]张晓飞,谢沐初,黄德荣,等.痔术后肛门狭窄手术中改良纵切横缝术的运用与体会[J].江西医药,2015,50(03):235-236.
[11]杜忠群,李艳德,王晓林,等.可吸收线改良纵切横缝术治疗重度医源性肛门狭窄4例[J].广西中医药大学学报,2014,17(01):55-56.
[2]中华中医药学会.中医肛肠科常见病诊疗指南[M].北京:中国中医药出版社,2012.36.
[3]国家中医药管理局.中医肛肠科病证诊断疗效标准[S].南京:南京大学出社,1995.132.
[4]MarvinL.Corman.结肠直肠手术[M].北京:人民卫生出版社,2002.176.
[5]李宇飞,王晓锋,李华山.医源性肛门直肠狭窄的诊断与治疗[J].世界华人消化杂志,2016,24(11):1632-1638+1621.
[6]贾志春,徐伟.肛门狭窄的手术治疗进展[J].内蒙古医学杂志,2016,48(04):440-442-500.
[7]张传举.肛门直肠狭窄的中西医结合治疗效果体会[J].中国实用药,2016,11(11):200-201.
[8]贾兰斯,李俊姣,范学顺.肛门狭窄的中西医诊疗研究进展[J].中日友好医院学报,2014,28(05):308-310.
[9]蒋艳,卢雪娇,乔峰妮,等.改良侧方纵切横缝内括约肌切断术治疗肛裂的临床效果观察[J].结直肠肛门外科,2018,24(S1):1-3.
[10]张晓飞,谢沐初,黄德荣,等.痔术后肛门狭窄手术中改良纵切横缝术的运用与体会[J].江西医药,2015,50(03):235-236.
[11]杜忠群,李艳德,王晓林,等.可吸收线改良纵切横缝术治疗重度医源性肛门狭窄4例[J].广西中医药大学学报,2014,17(01):55-56.