不同切开方式中医挂线疗法治疗肛瘘临床疗效及对肛肠动力学指标和复发的影响  

Effect of Medicated Thread Therapy of Traditional Chinese Medicine with Different Incision Methods on Clinical Efficacy,Anorectal Dynamics Index and Recurrence in Patients with Anal Fistula

作　　者：吴洪 弋坤 赵红波 WU Hong;YI kun;ZHAO Hong-bo(Department of Anorectal Medicine Integrated with Traditional Chinese and Western Medicine,Nanchong Central Hospital,Nanchong,Sichuan 637000,China;Department of Pediatrics,Jialing Branch of Nanchong Central Hospital/People's Hospital of Jialing District,Nanchong,Sichuan 637000,China)

机构地区：[1]南充市中心医院中西医结合肛肠科,四川南充637000 [2]南充市中心医院嘉陵分院·嘉陵区人民医院儿科,四川南充637000

出　　处：《解放军医药杂志》2021年第1期108-111,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省科技计划项目(19ZB0175)。

摘　　要：目的探讨不同切开方式中医挂线疗法治疗对肛瘘患者临床疗效、肛肠动力学指标及复发的影响。方法回顾性分析2015年10月—2019年10月本院收治的120例肛瘘患者的临床资料,根据治疗方法不同分为对照组68例和观察组52例,对照组采用低位部分切开高位挂线术治疗,观察组采用低位全部切开高位挂线术治疗。对比2组术后创面大小、创口愈合时间、临床疗效、肛管最大收缩压(AMCP)、肛管最长收缩时间(ALCT)、直肠静息压(RRP)、肛管静息压(ARP)水平及术后1年内复发率。结果观察组术后创面面积大于观察组,创口愈合时间明显长于对照组(P<0.01);2组总有效率比较差异无统计学意义(P>0.05);与术前比较,2组治疗后RRP、ARP水平显著显降低,且观察组低于对照组(P<0.05);观察组术后总复发率显著低于对照组(P<0.05)。结论两种中医挂线疗法各具优势,临床疗效显著且不影响排便功能,低位全部切开高位挂线术在降低术后复发率中优势相对更为明显。Objective To explore the effect of medicated thread therapy of traditional Chinese medicine with different incision methods on clinical efficacy,anorectal dynamics index and recurrence of anal fistula in patients.Methods The clinical data of 120 patients with anal fistula admitted to our hospital from October 2015 to October 2019 were retrospectively analyzed.According to different treatment methods,they were divided into a control group(low-level partial incision and high-level medicated thread therapy,n=68)and an observation group(low-level entire incision and high-level medicated thread therapy,n=52).The size of wounds,wound healing time,clinical efficacy after treatment,anal maximal contraction pressure(AMCP),anal longest contraction time(ALCT),rectal rest pressure(RRP),anal rest pressure(ARP)level and recurrence rate within 1 year were compared between the two groups.Results The wound surface of the observation group was larger than that of the observation group,and the wound healing time of the observation group was significantly longer than that of the control group(P<0.01);There was no significant difference in the total effective rate between the two groups(P>0.05).Compared with those before treatment,the RRP and ARP levels of the two groups were significantly lower after treatment,and the levels were lower in the observation group than in the control group(P<0.05).The total recurrence rate of the observation group was significantly lower than that of the control group(P<0.05).Conclusion The two medicated thread therapy of TCM have their own advantages,and the clinical effect is significant and does not affect the function of defecation.The low-level entire incision and high-level medicated thread therapy has a more obvious advantage in reducing the postoperative recurrence rate.

关 键 词：肛瘘 中医挂线疗法 肛管静息压 肛管最大收缩压 肛管最长收缩时间 复发 

分 类 号：R657.16[医药卫生—外科学]