Abstract: Objective To investigate the therapeutic effect of pathological anal fissure tissue resection on chronic anal fissure. Methods The clinical and follow-up data of 46 patients with chronic anal fissure who underwent pathological anal fissure tissue resection in our hospital from September 2019 to April 2020 were retrospectively analyzed. The operation time, intraoperative blood loss, postoperative complications, postoperative pain score, changes of anal canal resting pressure before and after surgery and clinical efficacy were observed. Results The operation time was （35.91±12.35） min, and the intraoperative blood loss was （7.33±3.48） ml. Postoperative urinary retention occurred in four cases （8.70%）, incision infection in one case （2.17%）, no incision bleeding, anal incontinence and other complications. Postoperative pain score： 24 h after operation （3.43±0.91）, 48 h after operation （3.00±0.73）, 72 h after operation （2.22±0.76）, one week after operation （0.67±0.63）. The resting pressure of anal canal was （19.86±2.24） kPa before operation and （10.396±1.97） kPa one week after operation, and the difference was statistically significant （P=0.000）. The wound healing time was （24.26±5.14） days. In this group, 42 cases （91.30%） were cured, 4 cases （8.70%） were improved, and the effective rate was 100%. The median follow-up time was 8 months, and no recurrence was found. Conclusion Pathological anal fissure tissue resection for chronic anal fissure is safe and effective.

Key words: chronic anal fissure, pathological anal fissure tissue resection, curative effect

摘要： 目的 探讨病理性肛裂组织切除治疗慢性肛裂的疗效。方法 回顾分析2019年9月至2020年4月在我院接受病理性肛裂组织切除手术46例慢性肛裂患者的临床及随访资料,观察患者手术时间、术中出血量、术后并发症情况、术后疼痛评分、手术前后肛管静息压变化及临床疗效。结果 本组患者手术时间（35.91±12.35）min,术中出血量（7.33±3.48）mL。术后出现尿潴留4例（8.70%）,切口感染1例（2.17%）,未出现切口出血、肛门失禁等并发症。术后24 h疼痛评分（3.43±0.91）分,术后48 h疼痛评分（3.00±0.73分,术后72 h疼痛评分（2.22±0.76）分,术后1周疼痛评分（0.67±0.63）分。术前肛管静息压（19.86±2.24）kPa,术后3周肛管静息压（10.396±1.97）kPa,差异具有统计学意义（P=0.000）。创面愈合时间为（24.26±5.14）d。本组患者治愈42例（91.30%）,好转4例（8.70%）,有效率100%。中位随访时间8.2个月,无复发病例。结论 病理性肛裂组织切除术治疗慢性肛裂安全、有效。

关键词: 慢性肛裂, 病理性肛裂组织切除术, 疗效