标题：肛门后正中切扩加肛窦切开引流术与内括约肌侧切术治疗慢性肛裂疗效比较

      作者：傅跃权，侯化森，周金良，罗海林    (东莞市凤岗人民医院外二科，广东 东莞 523695)

      卷次： 2018年29卷7期

      【摘要】 目的 比较肛门后正中切扩加肛窦切开引流术与内括约肌侧切术治疗慢性肛裂的临床疗效。方法 选择东莞市凤岗人民医院外二科于2013年5月至2017年6月期间收治的94例慢性肛裂患者为研究对象，根据随机数表法分为观察组和对照组，每组47例。观察组予肛门后正中切扩加肛窦切开引流术治疗，对照组予内括约肌侧切术治疗，比较两组患者术后疼痛情况、愈合时间、切口感染发生率，出院时比较两组患者的临床疗效；术后随访半年，比较两组复发情况。结果 治疗后，观察组患者的治疗总有效率为 100.00%，与对照组的 97.87%比较，差异无统计学意义(P>0.05)；观察组患者术后VAS评分为(4.2±1.4)分，明显高于对照组的(3.5±1.3)分，愈合时间为(16.9±4.3) d，明显长于对照组的(12.1±3.2) d，差异均有统计学意义(P<0.05)；观察组患者术后切口感染率为4.26%，随访期间复发率为6.38%，均明显低于对照组的14.89%和19.15%，差异均有统计学意义(P<0.05)。结论 肛门后正中切扩加肛窦切开引流术与内括约肌侧切术均是治疗慢性肛裂的有效术式，肛门后正中切扩加肛窦切开引流术的创伤相对较大，愈合时间较长，但是术后感染发生率及复发率均较低。
      【关键词】 慢性肛裂；肛门后正中切扩术；肛窦引流；内括约肌侧切术；疗效
      【中图分类号】 R657.1+4 【文献标识码】 A 【文章编号】 1003—6350（2018）07—1005—03

Clinical observation of posterior anus median incision combined with anal sinus incision drainage and lateralinternal sphincterotomy in the treatment of chronic anal fissure.
FU Yue-quan, HOU Hua-sen, ZHOU Jin-liang,LUO Hai-lin. Second Surgical Department, Dongguan Fenggang People's Hospital, Dongguan 523695, Guangdong, CHINA
【Abstract】 Objective To compare the clinical effect of posterior anus median incision combined with anal si-nus incision drainage and lateral internal sphincterotomy (LIS) in the treatment of chronic anal fissure. Methods Nine-ty-four chronic anal fissure patients who were treated in Second Surgical Department in Dongguan Fenggang People'sHospital from May 2013 to June 2017 were selected as the research objects. According to the random number table theywere divided into observation group and control group, with 47 patients in each group. The observation group receivedposterior anus median incision combined with anal sinus incision drainage, and the control group were treated with later-al internal sphincterotomy. The postoperative pain, healing time and incision infection rate were compared between thetwo groups. The clinical efficacy of the two groups was compared at discharge time. The recurrence rate of the twogroups were compared after six months of follow-up. Results After treatment, the total effective rate of observation·临床经验·doi:10.3969/j.issn.1003-6350.2018.07.037