分段开窗旷置结合切扩挂线置管引流术治疗复杂性肛瘘的临床研究  

Clinical study of windowing subsection,integrating free and put,cutting and expanding with thread drawing and tubing drainage for complex anal fistula

作　　者：何永恒[1] 王东宏[1] 赵鹏飞[1] 韩金红[1] 

机构地区：[1]湖南中医药大学第二附属医院国家重点肛肠科,湖南长沙410005

出　　处：《湖南中医药大学学报》2010年第3期64-67,共4页Journal of Hunan University of Chinese Medicine

基　　金：湖南省教育厅重点项目基金资助(08A051)

摘　　要：目的探讨分段开窗旷置结合切扩挂线置管引流术治疗复杂性肛瘘的有效性和安全性。方法根据诊断分类标准及排除、纳入标准纳入病例100例。试验组50例采用分段开窗旷置结合切扩挂线置管引流术,对照组50例采用切开挂线术。对两组主观性和客观性指标进行对比观察。结果试验组治愈率为98%,随访期内无复发;对照组痊愈率为88%,随访期内6例复发,复发率12%。两组术后在肛门失禁,肛门狭窄、移位、变形等方面差异有统计学意义(P<0.05);肛管直肠压力、直肠感觉和肛门节制功能检测结果显示试验组术前术后比较差异无统计学意义(P>0.05),对照组术前术后比较差异有统计学意义(P<0.05),两组术后比较差异有统计学意义(P<0.05)。结论与对照组相比,本术式具有治愈率高、复发率低、术后愈合时间短、瘢痕小、手术微创等优点。试验组在肛门功能保护方面明显优于对照组。Objective To investigate the validity and safety of.windowing subsection,inte-grating free and put,cutting and expanding with thread drawing and tubing drainage for complex anal fistula.Methods All 100 patients were divided into test group treated with the way of ＂windowing subsection,integrating free and put,cutting and expanding with thread drawing and tubing drainage＂ and control group with the way of ＂incision-thread-draw-ing＂.Results The cure rate in test group was 100%,without recurrence in follow-up period,and in control group 88%,with six cases of recurrence in follow-up period（12%）;the differences of postoperative incontinence,anal stenosis,displacement,deformation and so on between two groups were statistically significant（P〈0.05）;the differences of anal rectal pressure,rectal sensation and anal function before and after surgery were no statistically significant（P〉0.05）;the difference in the control group before and after surgery was statistically significant（P〈0.05）;the difference between two groups was statistically significant（P〉0.05）.Conclusion Com-pared with the control group,this technique has the advantages of a high cure rate,low relapse rate,short healing time,small scar and minimally invasive surgery.Test group in the anal function of protection is superior to the control group.

关 键 词：复杂性肛瘘 分段开窗旷置结合切扩挂线置管引流术 有效性 安全性 临床研究 

分 类 号：R657.16[医药卫生—外科学]