松弛挂线术与多切口引流术治疗复杂性肛周脓肿的临床疗效观察  

Clinical observation on the curative effects of loose seton placement and multi-incision drainage on treatment of complex perianal abscess

作　　者：陶琦 陈利民[1] 郑武[1] 何航行[1] 王宜慧 王伟民 TAO Qi;CHEN Li-min;ZHENG Wu(Department of Anorectal Surgery, the People′s Hospital of Macheng, Hubei 438300, China)

机构地区：[1]麻城市人民医院肛肠科,湖北438300

出　　处：《中国临床新医学》2020年第11期1120-1124,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：武汉市第四医院·麻城市人民医院科技人才培养专项科研基金项目。

摘　　要：目的观察松弛挂线术与多切口引流术治疗复杂性肛周脓肿的临床效果。方法纳入2018-01~2019-09该院收治的64例肛周脓肿患者为研究对象,随机分为观察组和对照组,每组32例。观察组行松弛挂线术,对照组行传统的多切口引流术。比较两组手术相关情况、疼痛评分、肛门功能评分、生活质量指数评分及并发症发生率。结果两组手术时间、住院周期、住院费用比较差异无统计学意义(P>0.05)。观察组术中出血量、总换药次数、>2 cm瘢痕数均显著优于对照组(P<0.05)。观察组术后1 d、7 d疼痛严重程度低于对照组,差异有统计学意义(P<0.05)。观察组术后1周、8周Wexner肛门失禁评分优于对照组,差异有统计学意义(P<0.05)。观察组术后2周、8周胃肠道生存质量指数评分显著优于对照组(P<0.05);两组术后并发症总发生率比较差异无统计学意义(χ2=0.674,P>0.05)。结论与传统的多切口引流术比较,松弛挂线术的近期疗效具有一定优势,为肛周脓肿提供了一种更简便、微创的治疗方法。Objective To observe the clinical effects of loose seton placement and multi-incision drainage on treatment of complex perianal abscess.Methods Sixty-four patients with perianal abscess admitted to the People′s Hospital of Macheng from January 2018 to September 2019 were included in this study,and were randomly divided into observation group and control group,with 32 cases in each group.The observation group received loose seton placement and the control group was treated with conventional multi-incision drainage.The operation-related situation,pain score,anal function score,quality of life index score and the incidence of complications were compared between the two groups.Results There were no significant differences in the operation time,hospitalization period and hospitalization expenses between the two groups(P>0.05).The amount of intraoperative bleeding,total number of dressing changes and the number of>2 cm scar in the observation group were significantly better than those in the control group(P<0.05).The severity degrees of pain in the observation group were lower than those in the control group 1 and 7 days after operation,and the differences were statistically significant(P<0.05).The Wexner anal incontinence scores of the observation group were better than those of the control group 1 week and 8 weeks after operation,and the differences were statistically significant(P<0.05).The gastrointestinal quality of life index scores of the observation group were significantly better than those of the control group 2 weeks and 8 weeks after operation(P<0.05).There was no significant difference in the overall incidence of postoperative complications between the two groups(χ2=0.674,P>0.05).Conclusion Compared with that of traditional multi-incision drainage,the short-term curative effect of loose seton placement has certain advantages,which provides a more simple and minimally invasive treatment for perianal abscess.

关 键 词：肛周脓肿 松弛挂线术 多切口引流术 

分 类 号：R657.15[医药卫生—外科学]