治疗肛旁脓肿如何减少肛门瘘管发生的临床体会(附127例报告)  

Method of Treatment and Clinical Traits in Perianorectal Abscess

作　　者：司徒光伟[1] 周珞华[2] 吕警军[1] 

机构地区：[1]武汉钢铁集团公司总医院肛肠外科,430080 [2]武汉科技大学医学部护理系,430065

出　　处：《结直肠肛门外科》2008年第4期244-246,共3页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨在治疗肛旁脓肿时如何减少肛门瘘管的发生。方法通过回顾性分析5年来我科收治的肛旁脓肿127例,通过不同的肛旁脓肿类型采用挂线与不挂线手术方式治疗,对术后肛门瘘管形成、复发脓肿以及术后肛门功能不良等情况进行分析比较,并进行统计学处理。结果(1)术后肛瘘发生率:单腔脓肿不挂线组11.4%(1/7),挂线组6.9%(2/29),P>0.05;多腔脓肿不挂线组60%(3/5),挂线组5.8%(4/69),P<0.05;高位脓肿切不挂线组83.3%(10/12),挂线组0(0/5),P<0.05。(2)术后复发脓肿:观察期内0例。(3)术后肛门功能不良:低位脓肿切排引流组无肛门功能不良,挂线组共3例,无失禁;高位脓肿轻度肛门功能不良共5例,无失禁。结论肛旁脓肿因在切排术后肛瘘发生率高,尤其是高位脓肿,减少肛门瘘管的发生,寻找潜在的内口是关键,同时要根据不同的肛旁脓肿类型选择相应手术方式。Objective To understand relations between cause and clinical traits of perianorectal abscess, and if is or no need treat potential factors that can cause anal fistula in treatment. Methods One hundred twenty seven patients with perianorecteal abscess systemic retrospective analyzed who were in hospital on our department and they were classified. The time of wound healing, formation of anal fistula, relapse abscess and complications of post-surgery were noted. And the following up data were gathered and were done by statistical treatment. Results （1） incidence rate of anal fistula ： simple abscess cavity incision and drainage group was 11.4% （1/7）, and thread-drawing therapy group was 6.9% （2/29）, and P〈 0.05. Multiple abscess cavities incision and drainage group was 60% （3/5）, and thread-drawing therapy was 5.8% （4/69）, and P 〈0. 005. Elevation abscess cavities incision and drainage group was 83.3 %（10/12）, and thread-drawing therapy group was 0 （0/5）, and P 〈0. 005, and significant difference. （2） recurrence abscess： there are no during observation. （3） anus dysfunction after operation： there was no case anus dysfunction in low-set perianorectal abscess incision and drainage group and there were 3 cases in thread- drawing therapy group and there were no incontinence, and 5 cases in elevation perianorectal abscess and there were no incontinence, too. And there were no anal incontinence. Conclusion incidence rate of anal fistula were higher after incision and drainage, especially elevation perianorectal abscess. So, we must find potential endostoma of abscess when we operate, and we can fall the incidence rate of anal fistula. When thread-drawing is right, there were no severe syndromes.

关 键 词：肛旁脓肿 肛瘘 

分 类 号：R657.1[医药卫生—外科学]