经括约肌间入路瘘管剔除虚挂术治疗肛瘘临床观察  

Clinical observation of treating anal fistula by removing fistulae through intersphincter approach

作　　者：刘刚 王冬梅 LIU Gang;WANG Dongmei(Department of Anorectal Medicine,Wuwei Hospital of Traditional Chinese Medicine,Wuwei,Gansu 733000,Chine;Department of Anorectal Medicine,Minqin County Hospital of Traditional Chinese Medicine,Wuwei,Gansu 733000,China)

机构地区：[1]甘肃省武威市中医医院肛肠科,甘肃武威733000 [2]甘肃省武威市民勤县中医医院肛肠科,甘肃民勤733000

出　　处：《新疆医学》2020年第11期1192-1194,共3页Xinjiang Medical Journal

基　　金：2019年甘肃省武威市市立科研项目(项目编号:WW1902047)。

摘　　要：目的讨论经括约肌间入路瘘管剔除虚挂术治疗括约肌间肛瘘的疗效和安全性及使用价值。方法选取武威市中医院肛肠科2018年10月至2019年10月符合标准的括约肌间单纯型肛瘘48例,随机分为观察组和对照组各24例,通过比较术后切口疼痛评分、切口分泌物评分、住院天数、切口愈合时间、三个月后回访治愈率及有无复发情况以及肛门功能及肛门形态的变化情况。结果两组术后前3 d,切口疼痛以及切口分泌物无明显差异,肛门形态、术前肛门功能无明显差异(P>0.05);术后第7天开始切口疼痛以及切口分泌物数量观察组明显优于对照组(P<0.05)。切口愈合时间以及住院天数观察组明显优于对照组(P<0.05),术后3个月以及复发率观察组明显优于对照组。结论经括约肌间入路瘘管剔除虚挂术治疗肛瘘与传统手术相比疗效更可靠,复发率低等优点。Objective To discuss the efficacy,safety and application value of the treatment of intersphincteric anal fistula with fistulectomy through intersphincteric approach.Methods 48 cases of simple anal fistula between sphincter in the Department of anorectal surgery of Wuwei Hospital of Traditional Chinese Medicine from October 2018 to October 2019 were selected and randomly divided into the observation group and the control group,with 24 cases in each group.The postoperative incision pain score,incision secretion score,hospitalization days,incision healing time,the cure rate after three months of follow-up,recurrence,anal function and anal morphology were compared.Results There was no significant difference in incision pain and incision secretion between the two groups in the first three days after operation,and there was no significant difference in anal morphology and anal function before operation(P>0.05);the incision pain and incision secretion quantity in the observation group were significantly better than that of the control group on the 7 th day after operation(P<0.05).The wound healing time and hospitalization days in the observation group were significantly better than that of the control group(P<0.05),and the recurrence rate in the observation group was significantly better than that of the control group at 3 months after operation.Conclusions Compared with traditional operation,the curative effect of the treatment of anal fistula by intersphincteric approach is more reliable and the recurrence rate is lower.

关 键 词：括约肌间肛瘘 手术 经括约肌间入路 

分 类 号：R615[医药卫生—外科学]