肉毒素注射对痔切除术后创面愈合的改善:一项双盲、随机研究

作     者：Patti R Almasio P.L Muggeo V.M.R. G. DiVita 尹勇 

作者机构：1st Surgical Division Department of Surgery University of PalermoVia Autonomia Siciliana 70 90143 Palermo ItalyDr. 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2006年第2卷第4期

页      面：12-13页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：痔切除术 肉毒素 术后创面 随机研究 肛门内括约肌 肛管直肠 痔患者 便时 内括约肌痉挛 术后疼痛 

摘      要：PURPOSE: Hemorrhoidectomy is usually associated with significant pain during the postoperative period. The spasm of the internal sphincter seems to play an important role in the origin of pain. This study was designed to evaluate the effectiveness of intrasphincter injection of botulinum toxin after hemorrhoidectomy in reducing the maximum resting pressure of the anal canal, accelerating wound healing, and decreasing postoperative pain when resting and during defecation. METHODS: Thirty patients with hemorrhoids of third and fourth degree were included in the study and randomized in two groups. Anorectal manometry was performed preoperatively and 5 and 30 days afterward in all patients undergoing Milligan-Morgan hemorrhoidectomy. One group received an injection of 0.4 ml of saline into the internal anal sphincter, the other group were injected with 0.4 ml of soluti on containing 20 units of botulinum toxin. RESULTS: After five days from hemorrhoidectomy, maximum resting pressure decreased in the group injected with botulinum toxin and increased in the placebo group. The time of healing and postoperative pain when resting and during defecation significantly decreased in the group treated with an injection of botulinum toxin. CONCLUSIONS: Botulinum toxin injec tion into internal anal sphincter after hemorrhoidectomy is effective in reducin g maximum resting pressure, time of healing, and postoperative pain both on rest ing and during defecation in absence of complications or side effects.