Akira Tsunoda, Nobuyasu Kano, Department of Surgery, Kameda Medical Center, Chiba 296-8602, Japan.
World J Gastrointest Surg. 2012 Nov 27;4(11):251-5. doi: 10.4240/wjgs.v4.i11.251.
To assess the physical and mental health of fissure patients before and after topical treatment with diltiazem.
Consecutive patients were enrolled prospectively into the study. Quality of life was measured with the short-forum 36 health survey (SF-36) before and after 6-wk treatment with diltiazem. Patients scored symptoms of pain, bleeding, and irritation using numeral rating scales at the initial and follow-up visits. Fissure healing was assessed and side effects were noted.
Fissures healed in 21 of 30 (70%) patients. There were significant reductions in the scores of pain, bleeding, and irritation after 1 wk of treatment, respectively. Four patients experienced perianal itching and one patient reported headache. When measured at baseline, pain and irritation showed a negative impact on two of the eight subscales on the SF-36, respectively (bodily pain and social functioning for pain; vitality and mental health for irritation). Repeating the SF-36 showed an improvement in bodily pain (P = 0.001). Patients whose fissures healed reported an improvement in bodily pain, health-perception, vitality, and mental health (P < 0.05).
Successful treatment of chronic anal fissure with topical diltiazem leads to improvement in health-related quality of life.
评估肛门裂患者在使用地尔硫卓局部治疗前后的身心健康状况。
连续患者前瞻性纳入本研究。使用简短的 36 健康调查（SF-36）在使用地尔硫卓治疗 6 周前后测量生活质量。患者在初始和随访就诊时使用数字评分量表对疼痛、出血和刺激症状进行评分。评估肛裂愈合情况并记录副作用。
30 例患者中有 21 例（70%）肛裂愈合。治疗 1 周后疼痛、出血和刺激评分分别显著降低。4 例患者出现肛周瘙痒，1 例患者报告头痛。基线测量时，疼痛和刺激分别对 SF-36 的八个子量表中的两个子量表产生负面影响（疼痛的躯体疼痛和社会功能；刺激的活力和心理健康）。重复 SF-36 显示躯体疼痛有所改善（P=0.001）。肛裂愈合的患者报告躯体疼痛、健康感知、活力和心理健康有所改善（P<0.05）。
成功地使用地尔硫卓局部治疗慢性肛门裂可改善与健康相关的生活质量。
