目的?评估针对慢性肛裂患者实施肛门后正中切扩加肛窦切开引流术与内括约肌侧切术的临床疗效。方法 选取 2019 年 12月至 2020 年 12月青岛市城阳区人民医院收治的 70 例慢性肛裂患者，按照随机数字表法分为试验组与参照组，各 35 例。参照组行内括约肌侧切术治疗，试验组行肛门后正中切扩加肛窦切开引流术治疗，比对两组手术前后炎性因子指标、手术相关指标、手术前后疼痛感得分及临床疗效的情况。结果 两组患者手术前 C反应蛋白（CRP）、白细胞介素 -6（IL-6）、肿瘤坏死因子 -α（TNF-α）水平比较，差异无统计学意义?（P ＞ 0.05），手术后两组患者炎性因子水平均低于治疗前，且试验组更低于参照组，差异有统计学意义?（P ＜0.05）。两组患者手术时长比较，差异无统计学意义?（P ＞ 0.05）。试验组愈合时长、住院时长均短于参照组，差异有统计学意义?（P ＜0.05）。两组患者手术前疼痛感得分比较，差异无统计学意义?（P ＞ 0.05）。试验组患者术后 3?d、7?d 疼痛感得分低于参照组，差异有统计学意义?（P ＜0.05）。试验组患者临床疗效?（94.29%）高于参照组?（74.29%），差异有统计学意义?（P ＜0.05）。结论 慢性肛裂患者行肛门后正中切扩加肛窦切开引流术治疗效果显著，能够术后炎症反应较轻，促进患者术后恢复，患者术后疼痛感水平相对较低。
Objective To evaluate the clinical effect of retroanal midline incision and dilatation combined with anal sinus incision and drainage and lateral internal sphincter incision in patients with chronic anal fissure. Methods ?A total of 70 patients with chronic anal fissure admitted to Qingdao Chengyang District People's Hospital from December 2019 to December 2020 were selected and divided into experimental group and control group according to random number table method，with 35 cases in each group. The control group was treated with lateral internal sphincter resection，and the experimental group was treated with retroanal midline incision and dilation combined with anal sinus incision and drainage. The indexes of inflammatory factors，operating-related indexes，pain scores before and after surgery and the clinical efficacy of the two groups were compared. Results?The c-reactive protein，interleukin 6 and tumor necrosis factor alpha levels of two groups of patients before surgery were no statistically significant difference（P ＞ 0.05），the inflammatory factor levels after the surgery of two groups were lower than before，and the experimental group’s inflammatory factor levels all lower than the control group，the difference was statistically significant?（P ＜ 0.05）. There was no significant difference in operation time between the two groups（P ＞0.05）. The healing time and hospitalization time of the experimental group were shorter than those of the control group?（P ＜ 0.05）. There was no significant difference in score of pain between the two groups?（P ＞0.05）.The score of pain in the experimental group was lower than that in the control group on day 3 and 7 after surgery，and the difference was statistically significant?（P ＜ 0.05）. The clinical efficacy of patients in the experimental group?（94.29%）was higher than that in the control group?（74.29%），and the difference was statistically significant?（P ＜ 0.05）.Conclusion?In patients with chronic anal fissure，the treatment effect of retroanal midline incision and dilatation combined with anal sinus incision and drainage is significant，which can reduce the level of inflammatory factors in patients and promote postoperative recovery，and the level of postoperative pain in patients is relatively low.