主管切开挂线支管旷置引流术治疗复杂性高位肛瘘的疗效及复发率观察  

Observation on the curative effect of main fistula dissected and seton branch exclusion drainage in the treatment of complex high position anal fistula and the recurrence

作　　者：陈笑吟[1] 

机构地区：[1]湖北省中医院,湖北武汉430000

出　　处：《结直肠肛门外科》2015年第5期320-323,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的观察主管切开挂线支管旷置引流术治疗复杂性高危肛瘘的临床效果及对患者复发率的影响。方法将我院2012年2月至2015年3月收治的54例复杂性高位肛瘘患者作为研究对象,以入院顺序编号,随机分为观察组与对照组两组,各为27例。对照组采用常规切开挂线术治疗,观察组则采用主管切开挂线支管旷置引流术治疗,比较两组治疗效果的差异,观察患者肛门功能的改善情况,两组均随访6个月,统计复发率。结果观察组总有效率为100.00%,明显高于对照组的85.19%,两组治疗有效率对比差异有统计学意义（P〈0.05）;观察组术后VAS分级0级占22.22%,轻度疼痛占55.56%,4~6级、7~10级所占比例分别为22.22%、0,其无疼痛、轻度疼痛比例明显低于对照组,中重度疼痛高于对照组,两组对比差异有统计学意义（P〈0.05）;观察组术后肛门括约肌功能正常占85.19%,高于对照组的40.74%,其轻度损伤、中度损伤分别占14.81%、0,均低于对照组,两组肛门括约肌功能损伤程度对比差异有统计学意义（P〈0.05）;观察组术后末次随访无复发,对照组复发率为14.81%,两组复发率对比差异有统计学意义（P〈0.05）;观察组创面愈合时间为（28.64±6.33）d,明显短于对照组的（39.87±9.55）d,两组对比差异有统计学意义（P〈0.05）。结论采用主管切开挂线支管旷置引流术治疗复杂性高位肛瘘患者,可提高治疗有效率,减轻患者术后疼痛程度,保护患者肛门功能,同时复发率较低,患者创面愈合时间短。Objective To observe the curative effect of main fistula dissected and seton branch exclusion drainage in the treatment of complex high position anal fistula and the effect on the recurrence rate in patients. Methods 54 cases of patients with complex high position anal fistula treated in our hospital from April 2011 to March 2015 were treated as the research objects. According to the order of admission, the patients were numbered and according to the random number table method, they were divided into the observation group and the control group of 2 groups with 27 cases in each group. The control group were treated by routine dissected and seton therapy while the observation group were treated by main fistula dissected and seton branch exclusion drainage. The curative effects in the 2 groups was compared. The improvement of anal function of patients was observed. The 2 groups were followed up for 6 months and the recurrence rate was statistically analyzed. Results The total effective rate of the observation group（100.00%） was significantly higher than that of the control group（85.19%）（P〈0.05）; After operation, grade 0 VAS grading in the observation group accounted for 22.22% and mild pain accounted for 55.56%. Grade 4-6 and 7-10 accounted for 22.22% and 0, respectively. The ratios of no pain and mild pain were significantly lower than those in the control group while the ratios of moderate and severe pain were higher than those in the control group（P〈0.05）; After operation, normal anal sphincter function in the observation group accounted for 85.19% which was higher than that in the control group（40.74%）. Mild pain and moderate and severe pain accounted for 14.81% and 0, respectively which were lower than those in the control group. The differences in the degree of anal sphincter function damage between the 2 groups were statistically significant（P 〈0.05）; At the end of follow-up after operation, there was no recurrence in the observation group while the recurrence rate in the control

关 键 词：复杂性高位肛瘘 切开挂线 引流 复发 

分 类 号：R657.16[医药卫生—外科学]