放射状切开联合隧道式对口浮线引流术治疗高位后蹄铁型肛瘘的疗效  

Clinical study of radial incision combined with tunnel-type floating float drainage in the treatment of high posterior ankle fistula

作　　者：曾华[1] 郑勇[1] 方园园[1] 冯上新 田社清[1] ZENG Hua;ZHENG Yong;FANG Yuanyuan;FENG Shangxin;TIAN Sheqing(Department of Anorectal,Wuhan Hospital of Traditional Chinese Medicine,Wuhan 430014,China)

机构地区：[1]武汉市中医医院肛肠科,武汉430014

出　　处：《实用医学杂志》2020年第21期2962-2965,共4页The Journal of Practical Medicine

基　　金：武汉市卫生计生科研基金项目(编号:WZ17B08)。

摘　　要：目的观察和评价放射状切开联合隧道式对口浮线引流术治疗高位后蹄铁型肛瘘的术式优劣及临床疗效。方法共收集符合纳入标准住院患者80例,按入院顺序分为放射状切开联合隧道式对口浮线引流术组(观察组,n=40)和弧形切缝(挂线)内口引流术组(对照组,n=40)。观察两组病例的关键指标,包括手术时间、术中出血量、术后疼痛等,不良反应指标如排尿障碍、肛门功能及预后随访指标等方面,进行结果分析。结果观察组在手术时间、术中出血量、术后第2-4天疼痛,排尿障碍优于对照组,差异有统计学意义(P<0.05);两组在术后伤口继发感染、肛门功能、愈合时间等方面差异无统计学意义(P>0.05)。结论放射状切开联合隧道式对口浮线引流术式具有明显优势,如可操作性强,且减少术后不良反应,能更好地保护肛门括约肌功能,是治疗高位后蹄铁型肛瘘的优良术式。Objective This study tried to observe and evaluate the pros and cons of radial incision combined with tunnel-type floating line drainage for the treatment of high posterior ankle fistula and its clinical efficacy.Methods A total of 80 inpatients meeting the inclusion criteria were collected.According to the order of admission,they were divided into a radial incision combined with tunnel-type floating thread drainage group(observation group,40 cases)and a curved suture(thread hanging)internal drainage group(control group,40 cases).The key indicators of the two groups of cases including operation time,intraoperative blood loss,postoperative pain,etc.,and adverse reaction indicators such as urination disorder,anal function and prognosis follow-up indicators were all observed and analyzed.Results The observation group was better than the control group in terms of operation time,intraoperative blood loss,pain during the 2~4 days after operation and urination disorder(P<0.05).The postoperative wound infection rates,anal function,healing time and other aspects,were all no significant difference between the two groups(P>0.05).Conclusion Radial incision combined with tunnel-type floating thread drainage has obvious advantages.The advantages included strong operability,reduction of postoperative adverse reactions,and better protection of the anal sphincter function.It was an excellent operation for the treatment of high posterior iron fistula formula.

关 键 词：放射状 隧道式 对口浮线引流 后蹄铁型肛瘘 临床研究 

分 类 号：R266[医药卫生—中医外科学]