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.

目的 对比分析自动弹力线痔疮套扎术(RPH)与外剥内扎术联合治疗及吻合器痔上黏膜环切术(PPH)单独治疗重度混合痔的临床疗效。方法 选取2017年5月—2018年5月我院收治的100例重度混合痔患者,将其随机分为研究组(50例)与对照组(50例)。对照组患者采取PPH治疗,研究组患者采取RPH联合外剥内扎术治疗,对比两组患者治疗效果、手术相关指标,并观察术后肛门功能评分差异。结果 研究组患者的临床疗效高于对照组(P<0.05);手术时间及术中出血量、住院时间两组患者比较,研究组低于对照组(P<0.05)。研究组患者术后干便、气体、稀便、生活方式发生变化、需衬垫等肛门功能评分低于对照组(P<0.05)。结论 RPH与外剥内扎术联合治疗重度混合痔效果优于单独应用PPH治疗,值得临床推广。

Objective To study the efficacy and its influence on anal function of RPH combined with external ligation and internal ligation in the treatment of severe mixed hemorrhoids. Methods 100 patients with severe mixed hemorrhoids admitted to our hospital from May 2017 to May 2018 were selected as research subjects. They were randomly divided into the study group and the control group, 50 cases in each group. The control group was treated with PPH, and the study group was treated with RPH combined with external stripping and internal ligation. The therapeutic effect and operation related indexes of the two groups were compared, and the postoperative anal function scores were observed. Results The clinical efficacy of the study group was higher than that of the control group (P<0.05), and the intraoperative bleeding volume, operation time and hospitalization time of the study group were lower than that of the control group (P<0.05). The anal function scores such as dry stool, gas, dilution, lifestyle changes and padding requirement in the study group were lower than those in the control group (P<0.05). Conclusion RPH combined with external stripping and internal ligation is better than PPH alone in the treatment of severe mixed hemorrhoids.