Hashmi Fazila, Siddiqui Faisal Ghani
Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad.
J Coll Physicians Surg Pak. 2009 Dec;19(12):750-3.
To assess and compare the effectiveness of topical 0.2% glycerl trinitrate (GTN) and topical 2% diltiazem (DTZ), in the management of chronic anal fissure.
Comparative, descriptive study.
Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad from September 2004 to August 2005.
Patients with chronic anal fissure were treated with topical 0.2% GTN (50 patients) and 2% DTZ (47 patients) application for 8 weeks, three times a day at peri anal area. Symtoms, recurrence, wound healing and side effects were compared. Data was analyzed using SPSS version 10 employing X2 test. A p-value below 0.05 were considered statistically significant.
There were 53 females and 44 males with a mean age of 30 years. Patients who received topical diltiazem (DTZ) showed statistically significant difference than those who were prescribed topical glycerl trinitrate terms of wound healing and side effects mainly the headaches (p=0.02 and 0.003 respectively). Improvement in symptoms (p=0.345) and recurrence rates (p=0.612) turned to be statistically insignificant although recurrence rate was lower with DTZ.
Chemical sphincterotomy is an effective first line management for chronic anal fissure. Both GTN and DTZ are equally effective in managing the chronic anal fissure. DTZ has fewer side effects, a better healing response and low recurrence rates.
评估并比较局部应用0.2%硝酸甘油（GTN）和局部应用2%地尔硫䓬（DTZ）治疗慢性肛裂的有效性。
对比性描述性研究。
2004年9月至2005年8月，在詹姆肖罗/海得拉巴的利亚卡特医学与健康科学大学外科。
慢性肛裂患者分别接受局部应用0.2% GTN（50例患者）和2% DTZ（47例患者）治疗，为期8周，每天在肛周区域涂抹3次。比较症状、复发情况、伤口愈合情况及副作用。使用SPSS 10.0版软件进行数据分析，采用卡方检验。p值低于0.05被认为具有统计学意义。
共有53名女性和44名男性，平均年龄30岁。接受局部应用地尔硫䓬（DTZ）的患者在伤口愈合和副作用（主要是头痛）方面与接受局部应用硝酸甘油的患者相比，差异具有统计学意义（p值分别为0.02和0.003）。症状改善情况（p = 0.345）和复发率（p = 0.612）差异无统计学意义，尽管DTZ的复发率较低。
化学性括约肌切开术是慢性肛裂有效的一线治疗方法。GTN和DTZ在治疗慢性肛裂方面同样有效。DTZ副作用更少，愈合反应更好，复发率更低。
