改良负压封闭引流技术加中药保留灌肠治疗肛周深部脓肿的临床研究  

Modified Negative Pressure Closed Drainage Combined with Retention Enema of Chinese Herbs on Deep Perianal Abscess

作　　者：陈诚 章慧[1] 韶建生 刘晓梅[1] 袁艳春[1] 浦红云 Chen Cheng;Zhang Hui;Shao Jiansheng(Rugao Hospital of TCM of Jiangsu Province, Jiangsu ,Rugao 226500, Chin)

机构地区：[1]江苏省如皋市中医院,江苏如皋226500

出　　处：《中国中医急症》2018年第6期1008-1011,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：江苏省南通市科技局青年医学人才科研基金立项课题(WQZ2015011)

摘　　要：目的观察改良负压封闭引流技术(VSD)加中药保留灌肠治疗肛周深部脓肿的临床疗效并探讨其机制。方法肛周深部脓肿患者100例按入院顺序随机分为两组,对照组患者采用脓肿切开引流术进行治疗,观察组患者则采用改良VSD加中药保留灌肠进行治疗。比较两组患者的临床疗效,观察两组患者手术时间、住院时间、创面愈合时间等各项指标,所有患者术后随访6个月,详细记录患者治疗后脓肿复发率和继发肛瘘率。分别检测术前、术后5、10 d时血常规:包括白细胞计数(WBC)、中性粒细胞计数(NEU)、中性粒细胞百分比(Neut%)等指标。结果观察组患者的总有效率为100.00%,明显高于对照组的90.00%(P<0.05)。观察组与对照组的手术时间分别为(25.58±1.69)min、(30.24±1.77)min;创面愈合时间分别为(45.78±1.01)d、(48.59±1.53)d;住院时间分别为(14.10±0.19)d、(16.89±1.04)d,差异有统计学意义(P<0.05);观察组患者的脓肿复发率2%和继发肛瘘率为4%,明显低于对照组的33.33%和20%(P<0.05)。两组患者治疗5 d及10 d后,血常规指标均有所下降,且观察组下降幅度明显优于对照组(P<0.05)。结论针对于肛周深部脓肿患者而言,应用改良VSD加中药保留灌肠治疗,相比较传统的方式具有临床治疗效果显著、并发症发生率低、患者恢复快、手术时间短以及安全性高等优势。Objective： To investigate the clinical value of vacuum sealing drainage（VSD） combined with traditional Chinese medicine retention enema on perianal deep abscess. Methods： The patients were randomly divided into the control group and the observation group. The control group were treated with abscess incision and drainage,while the observation group was treated with modified VSD and Chinese medicine retention enema. The clinical efficacy of two groups was compared;the operation time,hospitalization time,wound healing time and other indicators were observed;all the patients were followed up for 6 months with a detailed record of them about abscess recurrence rate and secondary fistula rate after treatment. The blood routine including white blood count（WBC）,neutrophil count（NEU）,neutrophil percentage（Neut%） and relative indexes were detected before operation and 5 days and 10 days after operation,respectively. Results： The total effective rate of the observation group was significantly higher than that of the control group. The operation time of the observation group and the control group was（25.58±1.69） minutes,（30.24±1.77） minutes,respectively;wound healing time was（45.78±1.01） days,（48.59±1.53） days;the time of hospital stay were（14.10±0.19） days,（16.89±1.04） days. The difference of the indexes above between the two groups was statistically significant（P〈0.05）. The abscess recurrence rate of the observation group was 2.00 and secondary fistula rate was 4.00%,significantly lower than that of the control group 33.33% and 20.00%,respectively,with significant difference（P〈0.05）. Before treatment,there was no significant difference in blood routine indexes between the two groups（P〈0.05）. After 5 days of treatment and10 days after treatment,the blood routine indexes of the two groups were all decreased,and the decrease of the observation group was significantly better than that of the control group,and the difference was statistically significant（P�

关 键 词：改良负压封闭引流 肛周深部脓肿 中药保留灌肠 

分 类 号：R657.1[医药卫生—外科学]