Petros J G, Rimm E B, Robillard R J
Dept. of Surgery, St. Elizabeth's Medical Center, Boston, MA 02135.
Am Surg. 1993 Oct;59(10):666-8.
Chronic anal fissures have a varied and often confusing clinical presentation. To clarify this picture, we retrospectively studied 172 patients to determine associations between patient characteristics and manifestations of these lesions. We found that anterior fissures and sentinel piles were significantly more common in women; pruritus and rectal drainage occurred significantly more often in men; and patients with a longer duration of symptoms and those with pruritus and drainage were more likely to have a fistula. Younger patients were more likely to report rectal bleeding. Patients with chronic anal pruritus or an anal abscess should be carefully evaluated for an anal fistula, since anorectal problems may recur if a fistula remains untreated.
慢性肛裂临床表现多样，常常令人困惑。为了厘清这一情况，我们对172例患者进行了回顾性研究，以确定患者特征与这些病变表现之间的关联。我们发现，前位肛裂和哨兵痔在女性中明显更为常见；瘙痒和直肠溢液在男性中更为常见；症状持续时间较长以及有瘙痒和溢液症状的患者更有可能患有肛瘘。年轻患者更有可能出现直肠出血。对于患有慢性肛门瘙痒或肛门脓肿的患者，应仔细评估是否存在肛瘘，因为如果肛瘘不治疗，肛肠问题可能会复发。
