垫棉压迫法治疗低位复杂性肛瘘术后创腔闭合的临床研究  

Clinical Research of Pad Compression Therapy for Postoperative Wound Closure of Low-complex Anal Fistulae

作　　者：沈晓[1] 曹永清[1] 姚一博[1] 王琛[1] 梁宏涛[1] Shen Xiao;Cao Yongqing;Yao Yibo;Wang Chen;Liang Hongtao(Department of Anorectal Surgery,Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院肛肠科

出　　处：《世界中医药》2019年第12期3228-3232,共5页World Chinese Medicine

基　　金：国家自然科学基金项目(81603624);上海市中医临床基地建设项目(ZY3-LCPT-1-1002);曹永清名中医工作室(YW004.029);上海申康医院发展中心临床科技创新项目(SHDC12014239)——隧道式拖线垫棉疗法治疗复杂性肛瘘推广应用研究

摘　　要：目的:观察和研究垫棉压迫法治疗低位复杂性肛瘘术后创腔闭合的临床疗效。方法:选取2011年5月至2013年12月上海中医药大学附属龙华医院收治的低位复杂性肛瘘拖线术后患者60例作为研究对象,按照单盲、随机、对照的设计方法分为对照组、观察组A和观察组B,每组20例。观察组A(坐压4 h/d)、观察组B(坐压8 h/d)、对照组(自然压迫),治疗结束后,观察3组疗效及愈合时间,并运用肛管直肠测压对治疗进行安全性评价。结果:3组患者创面愈合时间比较,观察组A、B的愈合速度明显优于对照组(P均<0.01)。分别比较治疗第3、5、7天创腔宽度减小率,观察组A、B加快创腔闭合的速度明显优于对照组(P均<0.01),其中治疗第5天,坐压8 h/d的效果明显优于坐压4 h/d(P<0.01)。分别比较治疗第3、5、7天创腔内肉芽组织Collagen-Ⅰ、Collagen-Ⅲ含量,观察组A、B与对照组差异有统计学意义(P<0.01),坐压2组之间比较,差异无统计学意义(P>0.01)。结论:垫棉压迫疗法作为“拖线疗法”治疗低位复杂性肛瘘的联合治疗方案能够有效促进瘘管创腔的快速闭合,减少瘢痕增生,缩短愈合时间。Objective:This study aimed to observe efficacy of pad compression therapy for postoperative wound closure of low-complex anal fistulae.Methods:This study includes 60 cases of low-complex anal fistulae patients after thread—dragging therapy.They are randomly divided into three groups as:Study group A(pad compression 4 h/d),Study group B(pad compression 8 h/d)and Control group(natural compression)according to the single blind,randomized and controlled design methods.The curative effect,time of healing,safety evaluation are all measured after treatment.Results:To time of healing,reduction rate of wound cavity,both two study groups are better than control group with significant difference.Study group B′wound healing better than study group A at 5 days after treatment(P<0.01).To Collagen-Ⅰ、Collagen-Ⅲcontent,both two study groups are lower than control group with significant difference.Between two study groups,there was no significant difference(P>0.01).Conclusion:Combined with thread-dragging therapy,pad compression therapy can be used to accelerate closure of wound cavity of low-complex anal fistulae.It can reduce scar proliferation,shorten time of healing.

关 键 词：低位复杂性肛瘘 拖线疗法 垫棉压迫法 创面愈合 

分 类 号：R266[医药卫生—中医外科学]