经括约肌间入路的闭式内括约肌侧切术治疗陈旧性肛裂的临床效果评价及发病特征

doi:10.20047/j.issn1673-7210.2023.13.21

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Abstract Objective To evaluate the clinical effect of closed internal sphincter sphincterotomy through intersphincter approach for the treatment of old anal fissure and its pathogenic characteristics. Methods Eighty-three patients with old anal fissure admitted to the Department of Anorectal, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January to December 2020 were selected and divided into treatment group (34 cases) and control group (49 cases) according to the surgical methods. The treatment group was treated with closed internal sphincterotomy through intersphincteric approach, while the control group was treated with anal fissure incision and expansion. The clinical effect, healing time, pain and bleeding at the third day after surgery, intraoperative blood loss, operation time, hospitalization cost, hospitalization time, and abnormal anal function and recurrence at three months after discharge of the two groups were analyzed, and the pathogenic characteristics of old anal fissure were summarized. Results The results of this study showed that most of the old anal fissure consisted of single fissure, which was mainly located at the six o’clock position. Most of the clinical symptoms were pain and bleeding, and most of the complications were sentinel hemorrhoids. Both groups were cured, and there was no abnormal anal function or recurrence at three months after operation. There were no significant differences in intraoperative blood lose, hospitalization cost, and hospitalization time between the two groups (P＞0.05). The pain and bleeding at the third day after surgery in the treatment group were less than those in the control group, the healing time was shorter than that in the control group, and the operation time was longer than that in the control group, the differences were statistically significant (P＜0.05). Conclusion Closed internal sphincterotomy through intersphincter approach for the treatment of patients with old anal fissure is effective, can accelerate postoperative rehabilitation, worthy of application and promotion.

Key words： Chronic anal fissure Pathogenic characteristics Intersphincter approach Closed lateral internal sphincterotomy

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	QIN Qin1 DONG Qingjun2 WANG Chen2

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QIN Qin1 DONG Qingjun2 WANG Chen2. Clinical effect evaluation of closed lateral internal sphincterotomy through intersphincteric approach in patients with chronic anal fissure and its pathogenic characteristics[J]. 中国医药导报, 2023, 20(13): 92-95.

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https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2023.13.21 OR https://www.yiyaodaobao.com.cn/EN/Y2023/V20/I13/92

[1] 田振国，陈平，韩宝. 中国成人常见肛肠疾病流行病学调查主要结论与建议[C]//中华中医药学会.中华中医药学会肛肠分会学术年会暨全国流调行业发布会，2015：19-23.
[2] Stewart DB，Gaertner W，Glasgow S，et al. Clinical Practice Guideline for the Management of Anal Fissures [J]. Dis Colon Rectum，2017，60（1）：7-14.
[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] 陈景星，唐凯，喻登明，等.改良式侧方纵切横缝术联合后位切扩引流术治疗慢性肛裂的临床疗效[J].中国现代医药杂志，2022，24（3）：70-73.
[5] 尚威，雍雅慧，郭志伟，等.硝酸甘油软膏联合硝苯吡啶治疗慢性肛裂的效果观察[J].现代消化及介入诊疗，2020， 25（8）：1103-1106.
[6] 张东铭.肛裂的现代概念[J].结直肠肛门外科，2001，7（4）： 1-5.
[7] Schouten WR，Briel JW，Auwerda JJ. Relationship between anal pressure and anodermal blood flow. The vascular pathogenesis of anal fissures [J]. Dis Colon Rectum，1994，37（7）：664-669.
[8] Gibbons M，Read NW. Anal hypertonia in fissures：Cause or effect？[J]. Br J Surg，1986，73（6）：443-445.
[9] 陈慧超，章蓓.扩肛法在肛肠疾病中的应用[J].中医临床研究，2021，24（13）：135-136.
[10] 陈淑玲，单苏圆.肛裂的病因病机与中医外治法[J].内蒙古中医药，2020，39（3）：151-153.
[11] 杜天聪，孟强，邹杰，等.钙通道阻滞剂对比硝酸酯类药物治疗慢性肛裂的临床疗效及安全性评价的Meta分析[J].中国医药导报，2017，14（26）：113-117.
[12] 闫曙华.观察肉毒素注射结合小针刀内括约肌部分切断术治疗Ⅰ、Ⅱ期肛裂的疗效和安全性[J].中西医结合心血管病电子杂志，2020，8（15）：60，87.
[13] 陆燚琴，孙卫东.肛侧小切口切断部分内括约肌刀切口缝合微创治疗肛裂[J].结直肠肛门外科，2020，26（S2）：10-11.
[14] 乔鲁冀，张春霞，高宏建.肛裂Y-V成形术联合莫匹罗星治疗慢性肛裂疗效分析[J].中国临床医生杂志，2021， 49（1）：85-87.
[15] 邢晋梁.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[J].名医，2020（1）：10-11.
[16] 曹国令，吴云翔.肛门后正中切扩术联合肛窦切开引流术治疗慢性肛裂的临床研究[J].浙江创伤外科，2020， 25（4）：669-670.
[17] 于海龙.肛门内括约肌部分切断术治疗肛裂的临床观察[J].世界最新医学信息文摘，2020，39（47）：72-74.
[18] 宋建波.肛裂切除联合括约肌松解术治疗肛裂75例疗效观察[J].中国肛肠病杂志，2020，40（10）：49-51.
[19] 张宁.肛门侧位与后侧位内括约肌部分切断术对慢性肛裂患者的疗效比较[J].河南医学研究，2020，29（28）：5215-5217.