Crohn氏病累及肛周和肛直肠的发生率为20～80%。约5%的肛直肠Crohn氏病患者无近段肠病变。近来对有慢性肛瘘和肛裂的肛直肠Crohn氏病患者采用外科治疗尚有争议。Alexander-Willianis及Buchmann(1980年)报道了61例随访10年的结果,发现大部分患者肛瘘和肛裂自愈。故对Crohn氏病的外科处理持保守态度。然而,Crohn等提倡对肛直肠疼痛的患者采用以部分肛门内括约肌切断为主的手术治疗。本文作者最近回顾了86例随访10年以上的一组病人。该组患者诊断时的平均年龄为32岁(8～68岁)。其中59例(68.6%)患有小肠Crohn氏病。46例(53.4%)有直肠外大肠病变。83例(95.3%)曾行部分小肠切除,31例(36%)曾行结肠切除。在随访期 Crohn’s disease affects the perianal and anorectal incidence of 20 to 80%. About 5% of patients with anorectal Crohn’s disease have no proximal bowel disease. Recently surgical treatment of patients with anorectal Crohn’s disease with chronic anal fissure and anal fissure is controversial. Alexander-Willianis and Buchmann (1980) reported 61 years of follow-up of 10 years of the results and found that most patients with anal fissure and anal fissure self-healing. Therefore, surgical treatment of Crohn’s disease is conservative. However, Crohn et al advocate the use of partial anal sphincter-cut surgery in patients with anal pain. The authors recently reviewed 86 patients who were followed up for more than 10 years. The average age at diagnosis was 32 years (range, 8 to 68 years). Of these, 59 (68.6%) had Crohn’s disease of the small intestine. 46 cases (53.4%) had rectal colorectal lesions. 83 cases (95.3%) had partial small bowel resection, 31 cases (36%) had colonic resection. During the follow-up period