Efficacy Analysis Of Internal Anal Sphincter Injection Of Botulinum Toxin Type A In Treatment Of Anal Fissure

Objective:Nowadays,diseases with unknown etiology and mechanism include anal fissure,and there is no unified plan for the first-line clinical treatment of anal fissure in various hospitals,each with its own advantages and disadvantages.With the increasing demand of minimally invasive surgery,less pain and quick recovery in recent years,the research direction of this project is to compare two surgical methods and analyze the application of a more optimized treatment plan to clinical practice.Methods:The study was conducted with the consent of the patient and the ethics committee.Patients admitted to the Department of Anorectal Surgery of Xinhua Hospital Affiliated to Dalian University between December 2019 and April 2020 who consented to surgery were collected,and these patients met the inclusion criteria.The subjects were randomly divided into two groups by typing information into Excel software.The first group was the observation group(30 cases),and the second group was the control group(30 cases).Patients in the first group were treated with intramuscular injection of botulinum toxin type A,and patients in the second group were treated with internal sphincter removal from the anal side.Results:1.The first pain measurement time was 24 hours after treatment,the observation group was 2(0～2),the control group was 2(2～4),the two groups of subjects pain difference was statistically significant(P < 0.05);The second pain measurement time was the first voluntary defecation after treatment.The observation group was 2(2～4)and the control group was 4(3.5～4.5).The difference in pain between the two groups was statistically significant(P < 0.05).The third pain measurement time was 7 days after treatment,the observation group was 0(0～2),the control group was 2(0～2),the two groups of subjects pain difference was statistically significant(P < 0.05).Pain was lower in the observation group than in the control group,and quality of life after treatment was higher in the observation group.2.The resting pressure of anal canal in patients was measured preoperatively,which was 13.71±0.98 k Pa in the observation group and 13.83±1.03 k Pa in the control group.There was no statistically significant difference in the resting pressure of anal canal between the two groups(P > 0.05).90 days after treatment,the resting pressure of anal canal was measured again,and it was 11.91±1.17 k Pa in the observation group and10.67±1.12 k Pa in the control group.The difference of resting pressure of anal canal 90 days after surgery between the two groups was statistically significant(P < 0.05).Paired sample t test was used for statistical analysis.The preoperative manometric values of patients and the manometric values 3 months after surgery were significantly different in the observation group in statistical analysis(P<0.05).There was significant difference in the control group(P<0.05).The results showed that the two treatments were effective for reducing the resting pressure of anal canal and could provide physiological basis for the cure of anal fissure.3.The mean time of the surgical incision in patients was 6 days(5-7 days)in the observation group and 8 days(7-10 days)in the control group.There was significant difference in the healing time between the two groups in the statistical analysis(P <0.05).The shorter the healing time,the better the treatment is for the patients to return to normal life as soon as possible.4.The cured proportion was calculated,and the results showed that 83% of the observation group and 93% of the control group were cured,and the ineffective proportion of both groups was 0%.The results showed that there was no statistical difference in the cured proportion between the two groups.Both groups were safe and effective in curing the disease.5.There were no postoperative complications,such as acute urine retention,edema on the edge of the surgical wound,and impaired anal function in both groups.Conclusion:Therefore,compared with the control group,the treatment regimen in the observation group was more simple in operation technique,with lower pain,faster wound healing and more practical value.