激光瘘管闭合术治疗复杂性肛瘘的临床研究  

Clinical study on Treatment of Complex Anal Fistula with Laser-Aided Fistula-Tract Closure

作　　者：宋冀涛 李全 杨晓华 张景华 SONG Ji-tao;LI Quan;YANG Xiao-hua;ZHANG Jing-hua(The second Hospital of Huayu General Hospital,Renqiu 062552,China)

机构地区：[1]华油总医院二部医院普通外科,任丘市062552

出　　处：《中国激光医学杂志》2021年第2期82-86,共5页Chinese Journal of Laser Medicine & Surgery

基　　金：华北油田矿区医疗卫生临床新技术应用研究(2019-HB-G0202)。

摘　　要：目的研究激光瘘管闭合术治疗复杂性肛瘘的临床疗效。方法选取2017年1月至2019年3月,复杂性肛瘘患者100例,随机数字法分为激光组和对照组,每组患者50例。激光组行激光瘘管闭合+内口闭合术,激光波长980 nm,功率12 W;对照组行传统肛瘘切开术。比较两组围手术期相关指标(手术时间、术中出血量、住院时间);术后1 d、3 d和5 d采用视觉模拟评分法(visual analogue scale,VAS)评估患者疼痛程度,术后1和6个月评估Wexner肛门失禁评分,术后6个月评估临床疗效。结果激光组患者平均手术时间为(13.1±2.8)min短于对照组(32.5±6.5)min;激光组术中平均出血量为(8.61±1.8)ml少于对照组(27.3±5.4)ml;激光组平均住院时间(7.42±1.5)d短于对照组(16.3±3.7)d;对照组术后1 d、3 d和5 d的VAS评分高于激光组,以上两组比较,差异均具有统计学意义(P<0.05)。对照组治疗总有效率为94%,激光组总有效率为98%,差异无统计学意义(P>0.05);对照组患者治愈率(62%)低于激光组(82%),两组比较差异具有统计学意义(P<0.05)。对照组及激光组患者术后1和6个月的Wexner肛门失禁评分分别为(1.93±0.5)分、(0.59±0.1)分和(1.15±0.4)分、(0.26±0.1)分,激光组分值均明显低于对照组,差异均具有统计学意义(P<0.05)。结论激光瘘管闭合术治疗复杂性肛瘘安全有效,具有创伤小、恢复快、疼痛轻等优势,值得临床推广使用。Objective To study the clinical effect of laser-aided fistula-tract closure in treating complex anal fistula.Methods Totally 100 patients of complex anal fistula who were eligible from Jan.2017 to Mar.2019 were selected and divided randomly and evenly into two groups.The patients in the laser group were given laser-aided fistula-tract closure operation and those in the control group traditional anal fistulotomy.The perioperative indexes of the two groups were recorded and compared,including operation time,intraoperative bleeding volume and length.The pain level,clinical effect and change to Wexner anal incontinence score were valuated with visual analogue scale(VAS)respectively on the 1 d,3 d and 5 d after the operation.Results The operation time was(13.1±2.8)min in the laser group and(32.5±6.5)min in the control group.The operation time was shorter in the laser group than in the control group.The intraoperative blood loss was(8.61±1.8)ml in the laser group and(27.3±5.4)ml in the control group.The amount of blood loss in the laser group was less than that in the control group.The hospitalization time of patients was(7.42±1.5)d,in the laser group and(16.3±3.7)d in the control group The hospitalization time of patients in the laser group was shorter and the recovery was faster.The VAS scores of the control group were(5.87±1.1),(4.33±1.0)and(1.96±0.4)on postoperative day 1,day 3,and day 5 respectively,and that of the laser group was(4.12±1.0),(2.86±0.7)and(0.87±0.2).The VAS scores of the laser group were lower than those of the control group and the difference were statistically significant(P<0.05).The total effective rate was 94%in the control group and 98%in the laser group,and the difference was not significant(P>0.05).The cure rate was 62%in the control group and 82%in the laser group,and the difference was statistically significant(P<0.05).There was no significant difference between the two groups in the score of Wexner anal incontinence before operation(P>0.05).The wexner anal incontinence score of

关 键 词：激光 激光瘘管闭合术 复杂性肛瘘 

分 类 号：R616.4[医药卫生—外科学] R657.14[医药卫生—临床医学]