括约肌间瘘管结扎术与黏膜瓣推移术治疗复杂性肛瘘的临床疗效比较  

Comparison of the clinical effects of intersphincteric fistula ligation and mucosal flap advancement in the treatment of complex anal fistula

作　　者：樊鹏[1] 徐红丽 王凯[1] 马冲[1] FAN Peng;XU Hongli;WANG Kai;MA Chong(Department of Colorectal Hernia Surgery,Binzhou Medical University Hospital,Binzhou256603,China)

机构地区：[1]滨州医学院附属医院结直肠疝外科,山东滨州256603

出　　处：《中国现代医生》2021年第16期75-78,共4页China Modern Doctor

摘　　要：目的探讨括约肌间瘘管结扎术与黏膜瓣推移术治疗复杂性肛瘘的术后有效率。方法收集2017年10月至2019年9月在我院行复杂性肛瘘手术治疗的患者95例,分为采用括约肌间结扎术的LIFT组(n=53)和采用经肛门直肠黏膜推移术的ERAF组(n=42),对两组的手术时间,术后疼痛VAS评分及术后创面愈合时间进行对比,并评价两种手术方式术后的有效率。结果ERAF组的手术时间与术后创面的愈合时间高于LIFT组,差异有统计学意义(P=0.000)。ERAF组术后VAS评分低于LIFT组(P=0.000)。LIFT组术后有效49例,无效4例,总有效率为92.45%,ERAF组术后有效39例,无效3例,有效率为92.86%,两种手术方式的术后有效率比较,差异无统计学意义(P>0.05)。术后3个月LIFT组有效随访50例,有效44例,无效6例,总有效率为88.00%;ERAF组有效随访39例,有效33例,无效6例,总有效率为84.62%,两种手术方式术后3个月的有效率比较,差异无统计学意义(P>0.05)。结论LIFT与ERAF对复杂性肛瘘术后均能取得良好的疗效。Objective To explore the postoperative effectiveness of intersphincteric fistula ligation and mucosal flap advancement in the treatment of complex anal fistulas.Methods A total of 95 patients who underwent complex anal fistula surgery in our hospital from October 2017 to September 2019 were collected and divided into two groups.The LIFT group(53 cases)was treated with intersphincter ligation,and the ERAF group underwent transanorectal mucosal transfer surgery.The operation time,postoperative pain VAS score and postoperative wound healing time were compared between the two groups.The postoperative effectiveness between the two surgical methods was evaluated.Results The operation time and postoperative wound healing time of the ERAF group were longer than those of the LIFT group,and the difference was statistically significant(P=0.000).The postoperative VAS score of the ERAF group was lower than that of the LIFT group(P=0.000).In the LIFT group,49 cases were effective and 4 cases were ineffective,with an effective rate of 92.45%.In the ERAF group,39 cases were effective and 3 cases were ineffective,with the total of effective rate of 92.86%.There was no statistically significant comparison of the effective rates of the two surgical methods at 3 months after operation(P>0.05).The postoperative effective rate of the two surgical methods was not statistically significant(P>0.05).In the LIFT group,50 cases were followed up three months after the operation,of which 44 cases were effective,6 cases were ineffective,and the total of effective rate was 88.00%.In the ERAF group,39 cases were followed up effectively,of which 33 cases were effective,and 6 cases were ineffective,and the total of effective rate was 84.62%.There was no statistically significant difference in the effective rates of the two surgical methods at three months after operation(P>0.05).Conclusion Both LIFT and ERAF for complex anal fistula surgery can achieve a good curative effect.

关 键 词：复杂性肛瘘 括约肌间结扎术 黏膜瓣推移术 肛门直肠瘘 

分 类 号：R657.1[医药卫生—外科学]