主灶切开联合弧形开窗术治疗复杂性肛周脓肿的疗效观察  

Effect of incision of main lesion combined with V-shape opening for complex peri⁃anal abscess

作　　者：苟松[1] Gou Song(Department of Anorectal Diseases,Ya’an People’s Hospital,Ya’an 625000,Sichuan,China)

机构地区：[1]雅安市人民医院肛肠科,四川雅安625000

出　　处：《结直肠肛门外科》2020年第4期475-478,共4页Journal of Colorectal & Anal Surgery

基　　金：四川省卫生计生委科研课题(16PJ410)。

摘　　要：目的探讨主灶切开联合弧形开窗术治疗复杂性肛周脓肿的临床疗效。方法选取2017年5月至2019年6月经本院确诊的96例复杂性肛周脓肿患者为研究对象,按照随机数字表法将96例复杂性肛周脓肿患者分为观察组(n=48,采用主灶切开联合弧形开窗术治疗)和对照组(n=48,采用主灶切开联合传统的引流术治疗)。观察比较两组切口的愈合时间、瘢痕面积的大小、疼痛程度评分(术后24 h、术后初次排便及初次换药时)、术后肛门功能、疗效、并发症及复发情况。结果观察组切口愈合的时间短于对照组,瘢痕面积小于对照组,术后24 h及初次换药时的VAS评分较对照组低,肛门指诊、肛门形态以及肛门失禁评分均较对照组低,肛管静息压及收缩压均较对照组高,差异均有统计学意义(均P<0.05);两组初次排便时VAS评分比较差异无统计学意义(P>0.05)。观察组总有效率为93.8%,较对照组的75%高,并发症总发生率为10.4%,较对照组的31.3%低,差异均有统计学意义(均P<0.05);两组复发率比较差异无统计学意义(P>0.05)。结论主灶切开联合弧形开窗术治疗复杂性肛周脓肿患者,能够有效地缩短切口愈合时间及减少瘢痕面积,减轻术后切口的疼痛,可较大程度地恢复肛门功能,降低并发症发生率。Objectives To investigate the effect of incision of main lesion combined with V-shape opening for patients with complex perianal abscess.Methods Ninety-six patients with complex perianal abscess diagnosed at our hospital from May 2017 and June 2019 were recruited.Furthermore,they were randomly assigned to treatment group(n=48,received incision of main le⁃sion and V-shape opening)and control group(n=48,received incision of main lesion and traditional drainage).Wound-healing time,scar size,pain visual analogue scale(VAS)scores(at 24 hours after surgery,at the first defecation after surgery,and the first change of dressing),postoperative anal function,efficacy,complications,and recurrence were compared between the two groups.Results Compared with the control group,the treatment group had a significantly shorter wound-healing time,smaller scar,lower pain VAS scores at 24 hours after surgery and the first change of dressing,lower scores of rectal examination,lower scores of anal morphology,and lower Wexner incontinence score(P<0.05).Anal resting pressure and squeeze pressure were also significantly higher in the treatment group than in the control group(P<0.05).Pain VAS score at the first defecation after sur⁃gery did not differ between the two groups(P>0.05).Overall efficacy was 93.8%in the treatment group,which was significantly higher than in the control group(75%,P<0.05).Overall incidence of complications was 10.4%in the treatment group,which was significantly lower than in the control group(31.3%,P<0.05).The incidence of recurrence was comparable between the two groups(P>0.05).Conclusion In patients with complex perianal abscess,the combination of incision of main lesion and V-shape opening can effectively shorten the wound-healing time,reduce scar,alleviate postoperative pain,facilitate anal function recovery,and reduce postoperative complications.

关 键 词：复杂性肛周脓肿 主灶切开 弧形开窗术 疗效 

分 类 号：R657.15[医药卫生—外科学]