苦劳汤坐浴辅助肛周脓肿内口封闭联合负压封闭引流技术治疗高位肛周脓肿临床观察  

Clinical Value of Sitz Bath with Kulao Decoction in Assisting Block Therapy of Internal Opening of Perianal Abscess Combined with Vacuum Sealing Drainage Technique in the Treatment of Patients with High Perianal Abscess

作　　者：王琳[1] 赵俊飞 唐茂山[1] 郑勇浪 WANG Lin;ZHAO Jun-fei;TANG Mao-shan;ZHENG Yong-lang(Anorectal Department,Dazhou Central Hospital,Dazhou,Sichuan 635000,China;Department of Clinical Laboratory,Dazhou Central Hospital,Dazhou,Sichuan 635000,China)

机构地区：[1]达州市中心医院肛肠科,四川达州635000 [2]达州市中心医院检验科,四川达州635000

出　　处：《解放军医药杂志》2021年第1期103-107,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省科技计划项目[17YYJC1924]。

摘　　要：目的分析苦劳汤坐浴辅助肛周脓肿内口封闭联合负压封闭引流技术治疗对高位肛周脓肿患者的临床价值。方法选取2011年1月—2018年12月收治的高位肛周脓肿138例,根据治疗方法分为研究组和对照组,每组69例。对照组行负压封闭引流技术,研究组在对照组基础上联合苦劳汤坐浴辅助肛周脓肿内口封闭术治疗。比较2组肛门括约肌功能、术后疼痛、创面愈合时间以及术后复发情况;治疗前后C反应蛋白(CRP)、白介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平;治疗前、治疗后1 d及治疗后1周血清血管内皮细胞生长因子(VEGF)、血小板衍生内皮细胞生长因子(PD-ECGF)条带灰度值。观察2组临床疗效。结果研究组Wexner评分、视觉模拟评分法(VAS)评分低于对照组,创面愈合时间短于对照组(P<0.01)。治疗后2组CRP、IL-6及TNF-α水平低于治疗前,且研究组低于对照组(P<0.05,P<0.01)。治疗后1周研究组VEGF与PD-ECGF条带灰度值高于对照组(P<0.01)。研究组临床总有效率高于对照组(P<0.01)。结论苦劳汤坐浴辅助肛周脓肿内口封闭联合负压封闭引流技术治疗高位肛周脓肿可抑制炎症反应、促进VEGF、PD-ECGF表达,在减轻疼痛、缩短愈合时间、增强括约肌功能、临床疗效方面优于单一负压封闭引流术。Objective To analyze the clinical value of sitz bath with Kulao decoction in assisting block therapy of internal opening of perianal abscess combined with vacuum sealing drainage technique in the treatment of patients with high perianal abscess(HPA).Methods A total of 138 patients with HPA treated in our hospital from January 2011 to December 2018 were selected as the research subjects.They were divided into a research group and a control group,with 69 cases in each group.The control group was treated with vacuum sealing drainage technique,and the research group was supplemented with sitz bath with Kulao decoction to assist block therapy of internal opening of perianal abscess.Anal sphincter function,postoperative pain,wound healing time,and postoperative recurrence were compared between the two groups.C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels were compared before and after treatment.Gray value of serum endothelial cell-derived growth factors(VEGF),platelet-derived endothelial cell growth factor(PD-ECGF)straps before treatment,at 1 day after treatment and 1 week after treatment,and clinical efficacy of both groups were compared.Results The Wexner score and VAS score of the research group were lower than those of the control group,and the wound healing time was shorter than that of the control group(P<0.01).The levels of CRP,IL-6 and TNF-αin the two groups were decreased after treatment,while the levels in the research group were lower than those in the control group after treatment(P<0.05,P<0.01).At 1 week after treatment,the gray values of VEGF and PD-ECGF in the research group were higher than those in the control group(P<0.01).The total effective rate of the reseaerch group was higher than that of the control group(P<0.01).Conclusion The sitz bath with Kulao decoction in assisting block therapy of internal opening of perianal abscess combined with vacuum sealing drainage technique can inhibit the inflammatory response and promote the expression of VEGF and PD-ECGF.I

关 键 词：高位肛周脓肿 苦劳汤 负压封闭引流术 内皮细胞生长因子 血小板衍生内皮细胞生长因子 C反应蛋白 

分 类 号：R657.15[医药卫生—外科学]