切挂选择缝合术治疗高位复杂性肛瘘临床随机多中心对照研究  

Clinical Study on the Treatment of High Complex Fistula-in-Ano by Using Incision Cutting Section Drainage and Selective Suture

作　　者：唐学贵[1] 赵自星[2] 吴映书[3] 

机构地区：[1]川北医学院附属医院,四川南充637000 [2]成都中医药大学附属医院,四川成都610075 [3]四川省中医药研究院附属医院,四川成都610041

出　　处：《四川中医》2006年第7期83-86,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：国家中医药管理局02034专项基金资助(编号:0203L9045)

摘　　要：目的:提高高位复杂性肛瘘的临床疗效,减少复发率,保护肛门感觉和自制功能。方法:设计一种具有中西医结合特色的“切开、挂线、选择性缝合”术式治疗高位复杂性肛瘘,运用样本估算,按全国高位复杂性肛瘘诊断标准及排除标准纳入病例144例,随机、单盲法分组,试验组72例用“切开、挂线、选择性缝合”术式,对照组72例用切开挂线开放引流术。两组病例均于术前和术后6个月随访期内采用直肠灌注法检测直肠感觉和肛门节制功能。结果:试验组72例全部一次性治愈,一次性治愈率100%,随访期内1例(1.39%)出现污染内裤,余未发现明显并发症及后遗症,肛门功能良好,平均疗程(26±2.1)天;对照组一次手术痊愈60例(83.33%),其余12例(16.67%)经二次切缝引流手术治疗而愈,随访期内1例(1.39%)复发,术后肛门皮肤缺损7例(9.72%)、稀便失禁2例(2.78%)、污染内裤10例(13.89%),平均疗程(38±6.7)天。直肠感觉和肛门节制功能检测结果:两组术前比较,P>0.05;试验组术前术后比较,P>0.05;对照组术前术后比较,P<0.05;两组术后比较,P<0.05。结论:与对照组相比,本疗法具有疗效好、痛苦小、疗程短、对直肠感觉和肛门节制功能损伤小、并发症和后遗症少等优点。Objective ： To raise cure rate of high complex fistula - in - ano and to protect the anal functions, also to reduce the recurrence rate, reduce the postoperative complication and defend the sphincteric continence. Methods： 144 cases consecutive patients with high complex fistula-in-ano were randomized two groups in one blind： 72 cases in the study group, 72 cases in the control group. The study group operation was a self-design operation by using incision cutting section drainage and selective suture, the control group was using incision, thread - drawing drainage. Test the rectal fluid sensory and anal continence function by the method of clyster. Results： The cure rate of the study group was 100 percent, the par times of care are 26 ± 2.1 days, Only one case was recurrece and the rate was 1.39 percent.The cure rate of the control group is 83.33 percent, The average Curedtime were 38 ± 6.7 days.The recurrece rate was 26.39 pereent.Test the rectal fluid sensory and anal continence function by the method of clyster show： compare the postoperative effect of the two groups, P 〈 0.05. Conclusions： Compared with the control group, the treatment group has advantages of less surgical injury, shortening treatment course, raising cure rate and protecting anal functions.

关 键 词：高位复杂性肛瘘 切挂缝合手术 临床研究 

分 类 号：R657.16[医药卫生—外科学]