低位挂线高位扩创引流术治疗高位肛瘘的临床观察  

Clinical Observation of Low Seton and High Opening-Drainage Therapy for High Anal Fistula

作　　者：张少军[1,2] 杨巍[1] 应光耀[2] 高洪娣[2] 熊国华[2] 

机构地区：[1]上海中医药大学附属曙光医院,上海201203 [2]上海市嘉定区中医医院,上海201899

出　　处：《世界中西医结合杂志》2013年第3期249-251,289,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：上海市中医临床优势专科建设项目(2008YSZK006);上海市嘉定区卫生系统重点学科建设项目(2009ZD05);上海市嘉定区卫生局科研资助项目(KYXM2009-12-12)

摘　　要：目的观察低位挂线高位扩创引流术治疗高位复杂性肛瘘的临床疗效。方法将100例高位复杂性肛瘘患者随机分为治疗组和对照组,每组50例。治疗组采用低位挂线高位扩创引流术,对照组采用低位切开高位挂线术。观察两组患者术后的疼痛程度、治愈时间、治愈率、随访6月后的复发情况、术后及6月后的Wexner评分等指标。结果两组患者术后疼痛程度在第0、3、7天差异有统计学意义(P<0.01),治疗组疼痛程度较轻,在第14天两组差异无统计学意义(P>0.05);两组患者治愈率及复发情况比较差异无统计学意义(P>0.05);与对照组比较,治疗组治愈时间明显缩短(P<0.01);两组患者Wexner评分在痊愈后、6月后比较,差异有统计学意义(P<0.01),治疗组Wex-ner评分明显降低。结论低位挂线高位扩创引流术治疗高位复杂性肛瘘术后疼痛轻,可缩短治愈时间,较好地保护肛门功能。Objective To observe the clinical efficacy of low seton and high opening - drainage therapy on high complex anal fistula. Methods 100 cases of high complex anal fistula were randomized into a treatment group and a control group,50 cases in each one. In the treatment group,the low seton and high o- pening- drainage therapy was adopted. In the control group, the low incision and high seton therapy was used. The postoperative pain severity, the healing time, the curative rate, the recurrence situation in 6 months follow - up visit and Wexner score after operation and in 6 months were observed in two groups. Results The differences in the postoperative pain severity were significant statistically in comparison in the 0th, 3rd and 7th days for the patients between two groups （ P 〈 0.01 ） separately. The pain severity was mild in the treatment group. On the 14th day, the difference was not significant statistically between two groups（P 〉 0.05 ）. The differences in the curative rate and recurrence were not significant statistically for the patients be- tween two groups（ P 〉 0.05 ）. Compared with the control group, the healing time in the treatment group was shorter apparently（ P 〈0.01 ）. Wexner score after curing and in 6 months was different significantly for the patients between two groups （P 〈 O. 01 ）. Wexner score in the treatment group was lower apparently. Conclu- sion The low seton and high opening - drainage therapy results in mild postoperative pain, shortens the cur- ative time and better protects anal function in the treatment of high complex anal fistula.

关 键 词：高位肛瘘 低位挂线术 扩创引流 临床研究 

分 类 号：R615[医药卫生—外科学] R657.16[医药卫生—临床医学]