顾氏外科特色多切口分段拖线疗法治疗低位复杂性肛瘘的多中心临床研究  

Gu's Surgical Characterstic Towing Therapy by Multiple Incision and Subsection in Treating Low Complex Anal Fistula: a Polycentric Clinical Study

作　　者：丁雅卿 董青军[1] 林晖 乔敬华 曹永清[1] DING Yaqing;DONG Qingjun;LIN Hui;QIAO Jinghua;CAO Yongqing(Longhua Hospital Shanghai University of TCM, Shanghai 200032, China;Tianshan TCM Hospital of Changning District;Fengxian TCM Hospital of Fengxian District)

机构地区：[1]上海中医药大学附属龙华医院,上海200032 [2]上海市长宁区天山中医医院 [3]上海市奉贤区奉贤中医医院

出　　处：《西部中医药》2018年第5期4-7,共4页Western Journal of Traditional Chinese Medicine

基　　金："十二五"国家科技支撑计划项目(编号2015BAI 04B00);上海市肛肠病中医临床研究基地建设项目(编号ZY3-LCPT-1-1002);上海市市级医院适宜技术项目(编号SHDC12014201)

摘　　要：目的:评价顾氏外科特色多切口分段拖线疗法治疗低位复杂性肛瘘的有效性及安全性。方法:采用多中心、随机对照的试验设计,3个临床研究中心按1∶1∶1随机纳入低位复杂性肛瘘患者120例,每一个分中心有治疗组、对照组各20例。治疗组采用多切口分段拖线法,对照组采用肛瘘切开术。比较2组治愈率、愈合时间,术后疼痛、渗出、发热积分,愈合后6个月肛管直肠压力、复发率及住院天数、费用。结果:治疗组在术后疼痛、术后渗出、愈合后6个月的肛管静息压改善方面优于对照组(P<0.05),在愈合时间、住院天数及住院费用方面少于对照组(P<0.05);2组治愈率比较差异无统计学意义(P>0.05),随访6个月无复发。结论:顾氏外科特色多切口分段拖线疗法治疗低位复杂性肛瘘具有术后痛苦小、愈合快,肛门功能损伤小等优势,疗效优于肛瘘切开术。Objective： To assess the effectiveness and the safety of Gu＇s surgical features towing therapy bymultiple incisions and subsection in treating low complex anal fistula. Methods： By adopting polycentric, randomizedcontrolled trial design, three clinical research centers included 120 patients with low complex anal fistula accordingto the ratio of 1：1：1 randomly, each branch center contained the treatment group and the control group, 20 cases eachgroup. The treatment group used towing therapy by multiple incisions and subsection, and the control group analfistulotomy. Cure rate, healing time, postoperative pain, exudation, and fever scores, anorectal pressure in six monthsafter healing, relapse rate, hospitalization days and expenses were compared between both groups. Results： Thetreatment group was superior to the control group in postoperative pain, postoperative exudation and anorectal pressurein six months after healing（P〈0.05）, less than the control group in healing time, hospitalization days and expensesobviously（P〈0.05）. The difference had no statistical meaning in the comparisons of healing rate between bothgroups（P〉0.05）, there was no relapse in six-month follow-up. Conclusion： Gu＇s surgical features towing therapy bymultiple incisions and subsection in treating low complex anal fistula possesses the advantages of little pain, quickhealing, small anal function and others, its effects are superior to these of anal fistulotomy.

关 键 词：肛瘘 低位复杂性 拖线疗法 多切口分段 外科特色 临床研究 多中心 顾氏 

分 类 号：R266[医药卫生—中医外科学]