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만성 치열 환자에 대한 GTN 국소요법과 보존적 치료의 효과 비교

Topical Glyceryl Trinitrate (GTN) Versus Conservative Treatment (CT) in Chronic Anal Fissure: Prospective and Randomized Study

대한대장항문학회지 2000년 16권 6호 p.360 ~ 364
이광렬 ( Lee Kwang-Ryul ) - 송도병원 외과

조경아 ( Jo Kyung-Ah ) - 송도병원 외과
황도연 ( Hwang Do-Yeon ) - 송도병원 외과
김건욱 ( Kim Khun-Uk ) - 송도병원 외과
박원갑 ( Park Won-Kap ) - 송도병원 외과
윤서구 ( Yoon Seo-Gu ) - 송도병원 외과
김현식 ( Kim Hyun-Sik ) - 송도병원 외과
이종균 ( Lee Jong-Kyun ) - 송도병원 외과


Purpose: This study was designed to compare the effect of treatment using glyceryl trinitrate (GTN) ointment with that of conservative treatment (CT) on chronic anal fissure.

Methods: As a preliminary study, maximal resting pressures of the anal canal were checked in 13 patients having chronic anal fissure before and 10 minutes after application of 0.2% GTN ointment. As the study groups, 59 patients having chronic anal fissure were randomly allocated to the GTN and the placebo groups. All the patients in both groups were given oral analgesics, sedatives, and bulk-forming agents. They had applied 0.2% GTN ointment or a placebo ointment three times a day to their perianal skin. Maximal resting pressures of the anal canal were checked at the beginning and at the endpoint of the treatment period which continued for 6 weeks. If there was complete healing of the fissure in the middle of the treatment, the treatment was stopped. Sixteen patients were lost during the study.

Results: Among the rest, 22 and 21 patients were included in the GTN group and the placebo group, respectively. The maximal resting pressure decreased significantly in all groups (p<0.05). The healing rates, the recurrence rates, and the operation rates were not significantly different between the GTN group and placebo group (p>0.05).

Conclusion: The effect of GTN on the symptomatic relief and results of treatment in patients having chronic anal
fissure is not superior to that of conservative treatment.


치열;글라이세린 트리나이트레이트 연고;보존적 치료
Anal fissure;Glyceryl trinitrate;Conservative treatment
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