中药灌肠结合负压封闭引流术治疗肛周深部脓肿临床研究  

Traditional herbal enema combined with vacuum sealing drainage for perianal abscess

作　　者：谈军 陈倚 刘晨 Tan Jun;Chen Yi;Liu Chen(Department of Anus-Intestines, Shanghai Putuo District Hospital of Traditional Chinese Medicine, Shanghai 200062, China)

机构地区：[1]上海市普陀区中医医院肛肠科,200062

出　　处：《国际中医中药杂志》2019年第6期589-591,共3页International Journal of Traditional Chinese Medicine

基　　金：上海市卫生和计划生育计划项目(20144Y0138).

摘　　要：目的评价中药灌肠结合负压封闭引流术治疗肛周深部脓肿的疗效。方法将符合入选标准的 87 例患者按随机数字表法分为对照组 43 例和研究组 44 例。对照组采用负压封闭引流术治疗,研究组在对照组基础上加用中药灌肠。 2 组均连续治疗 20 d,随访 6 个月。采用全自动血细胞分析仪检测WBC、中性粒细胞计数(neutrophil count, NEU)及中性粒细胞比例(NEU%),记录患者住院时间和创面愈合时间,观察随访期间脓肿复发率及和继发肛瘘情况。结果研究组总有效率为 97.7%(43/44)、对照组为 88.4%(38/43), 2 组比较差异有统计学意义(χ2=4.010, P=0.045)。研究组住院时间[(14.2±0.6)d 比(17.0±1.2)d, t=13.970]及创面愈合时间[(45.6±0.7)d 比(48.7±1.2)d, t=15.216]均较对照组较缩短(P<0.01)。治疗后,研究组 WBC、 NEU、 NEU%水平均低于对照组(t 值分别为 23.318、 12.827、 46.630, P值均<0.01)。随访 6 个月,研究组脓肿复发率与继发肛瘘率均明显小于对照组(χ2 值分别为 12.813、 4.225,P<0.01)。结论中药灌肠联合负压封闭引流术可明显缩短住院时间及创面愈合时间,减少脓肿复发和继发肛瘘的发生,提高临床疗效。Objective To evaluate the efficacy of traditional herbal enema combined with vacuum sealing drainage in the treatment of perianal abscess. Methods A total of 87 patients who met the inclusion criteria were randomly divided into control group (43 cases) and study group (44 cases) by random number table method. The control group was treated with vacuum sealing drainage. The study group was given traditional herbal enema on the basis of the control group. Both groups were treated for 20 days and followed up for 6 months. The WBC, neutrophil count (NEU) and neutrophil percentage (NEU%) was measured by automatic blood cell analyzer, and the hospitalization and wound healing time was recorded. The recurrence rate of abscess and secondary anal fistula was observed during the follow-up period. Results The total effective rate was 97.7%(43/44) in the study group and 88.4%(38/43) in the control group. There was significant differences between the two groups (χ2=4.010, P=0.045). The hospitalization time (14.2 ± 0.6 d vs. 17.0 ± 1.2 d, t=13.970) and wound healing time (45.6 ± 0.7 d vs. 48.7 ± 1.2 d, t=15.216) in the study group was significantly shorter than those in the control group (P<0.01). After treatment, the WBC, NEU and NEU% level in the study group was significantly lower than those in the control group (t=23.318, 12.827, 46.630, all Ps<0.01). After 6 months of follow-up, the recurrence rate of abscess and the secondary anal fistula rate in the study group was significantly lower than those in the control group(χ2=12.813, 4.225, respectively, P<0.01 or P<0.05). Conclusions Traditional herbal enema combined with vacuum sealing drainage can significantly shorten the hospitalization and wound healing time, reduce the recurrence of abscess and secondary anal fistula, and improve the clinical efficacy.

关 键 词：肛肠疾病 负压伤口疗法 引流术 灌肠疗法 

分 类 号：R657.15[医药卫生—外科学]