| Objective:Research anal fissure treatment of anal fissure and discuss curative effect and safety of ano-dilatation sphincterotomy.Manometric judgement of this method for solving the spasm of internal sphincter. Evaluate the situation of anal function.Method:Patients with anal fissure of III phase were selected in Nanjing City, anorectal Hospital of traditional Chinese medicine from February 2015 to January 2016.30 cases were randomly selected as study group.37 volunteers without anal disease were selected as control group.The treatment of study group is ano-dilatation sphincterotomy with manometry before and after healing.Through their own control, observe effectively their clinical symptoms,such as fissure, sentinel pile, Anal papilloma, pain, bleeding, constipation, diarrhea, etc. Observe the hole healing time,the result of manommetry and Wexner scores. All data results were statistically analyzed using SPSS22.Using Pearson card side validation for the count of paired data, and T test for the amount of paired data. Compairing the result of all manometric data.Difference is significant while P<0.05.Result:there were 30 fissure patients,20 women and 10 men;mean age was 42.33± 9.59 Follow-up was 3 mouths.The longest course of disease was 20 years, and the shortest was 6 weeks.29 patients were present as a single tear and only 1 patient presents as multiple fissures. 6.67%of patients were present as a anterior tear while 90% present as a posterior,3.33% with lateral. Patients with anal papilloma (43.33%), sentinel pile(46.67%), Subcutaneous fistula(6.67%), hemorrhoids (46.67%). Presenting symptoms included bleeding(100%), pain(100%), constipation(46.67%), ankyloproctia (3.33%), pruritus ani(0%) and diarrhea(0%). Fissure healing rate was 96.67%, and one patient was improved. The mean healing time was 37.39±9.82days.There was no incontinence postoperatively. With following up 3 mouths,there was no report of recurrence. The results of manometry:Preoperative ASRP was 70.57±14.27 mmHg,postoperative ASRP was 63.73±7.52mmHg(P=0.025),it was statistical significance. Comparing with postoperative ASRP, the healthy group’s was 63.65±7.04mmHg(P>0.05).There was no statistical significance. Others’ index of different groups had no significance, although the postoperative maximal squeeze pressure was 109±13.88mmHg(P>0.05), lower than preoperative and healthy groups.Conclusion:This research studys curative effect of ano-dialation sphincterotomy for III phased fissure. Preoperative ASRP was significantly higher than the healthy group’s. Conform to the theory of internal sphincter spasm.patients treated by ano-dialation sphincterotomy could significantly decrease ASRP. And there was no statistical difference between postoperative and healthy control group, postoperative MSP decreased slightly, but there was no significance druing there three groups. No case of incontinence was present. Therefore, ano-dialation sphincterotomy can effectively relieve clinical symptoms and solve the spasm of internal sphincter,high healing rate,low recurrence rate,and less postoperative complications or not. |
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