肛门直肠周围脓肿一期根治术的临床疗效观察  

OBSERVATION AND ASSESSMENT OF THERAPEUTIC EFFECTS OF PRIMARY CURATIVE INCISION IN THE TREATMENT OF PERIANORECTAL ABSCESS

作　　者：杜卫东[1] 郑卫平[1] 陆琪[1] 刘军[1] 杨俭英 

机构地区：[1]上海华东医院普外科,200000 [2]上海华东医院信息科

出　　处：《大肠肛门病外科杂志》2002年第3期145-147,共3页Journal of Coloproctological Surgery

摘　　要：目的 :观察和评估一期根治术治疗肛门直肠周围脓肿的临床疗效。方法 :将 12 6例急性肛门直肠周围脓肿病例分成一期根治性切开术组 (PCID组 ) ,和单纯切开引流组 (TID组 ) ,观察一期根治性手术治疗肛门直肠周围脓肿的临床疗效。观察 2组病例术后感染控制情况 ,创面愈合时间 ,随访术后 2年内的脓肿复发情况和肛瘘发生情况。结果 :PCID组病例术后感染控制时间 (5± 3d)较 TID组病例 (7± 4 d)明显缩短 ,2者存在显著差异 (P <0 .0 5 ) ;2组病例创面愈合时间无显著差异 (P >0 .0 5 ) ;PCID组病例术后脓肿复发需再次手术的病例为 2例 (发生率 3.13% ) ,TID组病例术后脓肿复发需再次手术的病例为 12例 (发生率 18.75 % ) ,2组病例存在非常显著差异 (P <0 .0 1) ;PCID组病例术后后遗肛瘘的病例为 2例(发生率 3.13% ) ,TID组病例术后后遗肛瘘的病例为 2 9例 (发生率 4 6 .77% ) ,2组病例存在非常显著差异 (P <0 .0 1)。结论 :一期根治术治疗肛门直肠周围脓肿较单纯切开引流手术存在明显的优越性 ,能明显地缩短术后感染控制时间 ,降低术后脓肿的复发率和肛瘘的发生率 ,缩短了病程 ,降低了再次手术的机率 。Objective:To observe and assess the therapeutic effects of primary curative incision in treatment of perianorectal abscess.Methods:126 cases of perianorectal abscess were divided into 2 groups in a randomized control study in our hospital from 1992 to 2001:the primary curative incisional drainage group (Group PCID) and the traditional incisional drainage group (Group TID).To observe and assess the length of the infection curing time and the healing time and relapse rate for 2 years postoperatively.Results:The infection curing time of Group PCID (5±3 days) was much shorter than that of Group TID (7±4 days) (P<0 05).There was no much difference between the healing time of cases of Group PCID and Group TID (P>0 05).There were fewer cases of reformation of recurrent abscess in Group PCID (2 cases,rate:3 13%) than that in Group TID (29 cases,rate:18 75%).And there was lower postoperative fistula formation rate in Group ICID(2 cases,3 13%) than that in Group TID (29 cases,46 77%).Conclusion:The result of primary curative incsisional drainage in comparison with the traditional incisional drainage showed that the incidence of postoperative fistula formation was 3 13% in the former and 46 77% in the latter,and it also show that the incidence of abscess recurrence was 3 13% in the former and 18 75% in the latter.The cases of Group PCID also had a short infection curing time than that of Group TID (P<0 05).The key points of the procedure were to find the real internal entrance,to choose a suitable cut,to treat the patients suitably after operation,to use adapt antibiotics,and to use incisional and thread-drawing drainage to treat high perianorectal abscess.

关 键 词：疗效 肛门直肠周围脓肿 根治术 切开引流术 

分 类 号：R657.15[医药卫生—外科学]