分段开窗旷置结合切开挂线置管引流术治疗复杂性肛瘘的临床研究  

Clinical Study on the Procedure of Segmental Fenestration, Retained Plus Incision, Thread-drawing and Drainage in the Treatment of Complex Anal Fistula

作　　者：何永恒[1] 王东宏[1] 赵鹏飞[1] 

机构地区：[1]湖南中医药大学第二附属医院肛肠科,湖南长沙410005

出　　处：《中国肛肠病杂志》2010年第9期9-12,共4页Chinese Journal of Coloproctology

基　　金：湖南省教育厅重点项目基金资助（NO.08A051）

摘　　要：为探讨分段开窗旷置结合切开挂线置管引流术治疗复杂性肛瘘的有效性和安全性，将复杂性肛瘘100例随机分为两组。试验组50例采用分段开窗旷置结合切开挂线置管引流术，对照组50例采用切开挂线术。对两组疗效、肛门功能、创面瘢痕、肛管直肠测压等指标进行对比研究。结果显示，试验组一次手术治愈49例，显效1例，治愈率98％，随访期内无复发。对照组一次手术治愈44例，显效5例，有效1例，治愈率88％，随访期内6例复发，复发率12％。试验组在术后肛门失禁、肛门狭窄、移位、变形等方面均优于对照组（P〈0．05）；在肛管直肠压力、直肠感觉和肛门节制功能方面试验组优于对照组（P〈0．05）。结果表明，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，手术损伤小等优点。试验组在肛门功能保护方面明显优于对照组。The objective of the study was to evaluate the efficiency and safety of the procedure of segmental fenestration, retained plus incision thread-drawing and place tube drainage（SFR plus ITD） in the treatment of complex anal fistula（CAF）. One hundred patients with CAF were randomised into two groups,50 cases underwent SFR plus ITD （the study group）, while 50 cases incision and thread-drawing （the control group）. As results,primary cure was achieved in 49 cases（98%）,marked improvement in one case and no recurrence was found during follow up in the study group; while in the control group primary cure was achieved in 44 cases（88%） ,marked improvement in 5 cases,improvement in one case and there were 6 recurred cases（12 % ）. The therapeutic results in the prevention of fecal incontinence, anal stricture, displacement ＆ deformity were better in the study group than that in the control group（ P 〈0.05） ,and the improvement in anorectal pressure,rectal sensation and anal control function was better in the study group than that in the control group（ P 〈0.05）. It is concluded that the procedure of SFR plus ITD is of such strong points as higher cure rate, lower recurrence rate, shorter recovery time, smaller scar, less trauma and better protection of anal function.

关 键 词：肛瘘 手术 临床研究 

分 类 号：R657.160.5[医药卫生—外科学]