中医挂线疗法治疗婴幼儿肛瘘的疗效观察及预后影响  

Curative efficacy of thread hanging therapy for infantile anal fistula and its prognostic effect.

作　　者：陈一平[1] 蔡容平 周小渔 唐华健[1] 李春景[1] 刘国庆[1] 黄振强[1] Chen Yiping;Cai Rongping;Zhou Xiaoyu;Tang Huajian;Li Chunjing;Liu Guoqing;Huang Zhenqiang(Department of Surgery,Municipal Women&Children's Health Center,Foshan 528000,China)

机构地区：[1]佛山市妇幼保健院外科,广东省佛山市528000

出　　处：《临床小儿外科杂志》2020年第7期636-640,共5页Journal of Clinical Pediatric Surgery

基　　金：佛山市科学技术局立项课题(编号:2017AB002871)。

摘　　要：目的探讨中医挂线疗法治疗婴幼儿肛瘘中的疗效,并评估其对预后的影响。方法选择2014年1月至2015年12月于佛山市妇幼保健院外科就诊的肛瘘患儿100例作为研究对象,年龄最大7个月,最小17天,采用随机数字表法将患儿分为研究组(n=50)与对照组(n=50),对照组患儿采用常规切开引流和清创治疗,研究组患儿采用中医挂线疗法治疗,比较两组患儿的临床疗效。结果研究组患儿术后Flacc评分显著低于对照组,排便情况显著优于对照组(P<0.05);研究组患儿的治疗总有效率显著高于对照组,治疗后的肛肠动力学指标改善程度显著优于对照组,差异均具有统计学意义(P<0.05)。所有病例均随诊到3岁以后,通过术后跟踪调查发现,两组患儿控便功能无明显差异,均未出现漏气、漏液等情况。结论中医挂线疗法可有效改善肛瘘婴儿的肛肠动力学指标,临床疗效良好。Objective To explore the clinical efficacy of thread hanging therapy of traditional Chinese medicine(TCM)in the treatment of infantile anal fistula.Methods From January 2014 to December 2015,a total of 100 infants with anal fistula were recruited and divided via a random number table into study group(n=50)and control group(n=50).The control group underwent conventional incision,drainage and debridement while the study group received thread hanging therapy of TCM.Results The score of the longest contraction time of anal canal(flacc)was significantly lower in study group than that in control group and defecation was significantly better than that in control group(P<0.05).The total effective rate was significantly higher in study group than that in control group(96%vs.78%,P<0.05).The improvements of such anorectal motility parameters as rectal venous pressure(RRP,2.31±0.13 kPa),anal venous pressure(ARP,13.02±0.24 kPa),anal maximum systolic pressure(AMCP,14.02±2.42 kPa)and alct(38.06±2.81 s)were significantly better in study group than those in control group(P<0.05).During a follow-up period of 3 years,no significant inter-group difference existed in defecation control function and there was no leakage of air or liquid.Conclusion Thread hanging therapy of TCM may effectively improve anorectal motility of infants with anal fistula.With an excellent clinical efficacy,it is worth further popularizing.

关 键 词：直肠瘘 挂线法 治疗结果 预后 婴儿 

分 类 号：R729[医药卫生—儿科] R657.18[医药卫生—临床医学]