前瞻性临床试验比较括约肌切开术、硝酸甘油软膏和利多卡因/乳果糖联合治疗肛裂。

Prospective clinical trial comparing sphincterotomy, nitroglycerin ointment and xylocaine/lactulose combination for the treatment of anal fissure.

机构信息

1st Propedeutic Surgical Clinic, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

Tech Coloproctol. 2010 Nov;14 Suppl 1:S21-3. doi: 10.1007/s10151-010-0610-3.

DOI:10.1007/s10151-010-0610-3

PMID:20683754

Abstract

BACKGROUND

The aim of this study is to compare the ability of three treatments in patients with anal fissure, sphincterotomy, nitroglycerin ointment and combination of gel xylocaine and lactulose.

METHODS

Ninety adults divided in three groups of 30 patients each group, received one of the three treatments in a 3-year interval (2007-2009) and the follow-up was for 2 months. Group A received nitroglycerin ointment, Group B underwent sphincterotomy and Group C received gel xylocaine and lactulose.

RESULTS

Concerning pain, after treatment 60% of patients in Group A did not complain of pain, 20% had transient pain, another 10% moderate pain and the remaining 10% had severe pain. In Group B, 95% of the patients had no pain and only 5% had mild, transient pain. In Group C 60% of the patients had moderate pain and the other 40% suffered from severe pain. Concerning fissure healing, in 60% of the patients of Group A, the fissure was healed. In Group B fissure healed in 93.3% and in Group C only in 16.6% of the patients.

CONCLUSION

The "gold standard" for anal fissure treatment is the lateral internal sphincterotomy and that each one of the three methods has its advantages and disadvantages.

摘要

背景

本研究旨在比较三种治疗方法在肛裂患者中的疗效，即括约肌切开术、硝酸甘油软膏和利多卡因凝胶与乳果糖的联合治疗。

方法

90 名成年人分为三组，每组 30 人，在 3 年的时间内（2007-2009 年）接受三种治疗方法中的一种，随访时间为 2 个月。A 组接受硝酸甘油软膏治疗，B 组接受括约肌切开术，C 组接受利多卡因凝胶与乳果糖治疗。

结果

在疼痛方面，治疗后 A 组 60%的患者无疼痛，20%的患者有短暂疼痛，10%的患者有中度疼痛，10%的患者有重度疼痛。B 组 95%的患者无疼痛，仅 5%的患者有轻度、短暂疼痛。C 组 60%的患者有中度疼痛，其余 40%的患者有重度疼痛。在肛裂愈合方面，A 组 60%的患者肛裂愈合。B 组肛裂愈合率为 93.3%，C 组仅为 16.6%。