地奥司明联合高频电刀肛瘘根治术对肛瘘患者的疗效  

Clinical efficacy of diosmin combined with radical resection of anal fistula with high frequency electric knife in treating anal fistula

作　　者：高维鸽[1] 阿布都维力·阿布都热合曼 GAO Weige;Abudou Weili·Abudou Reheman(Department of Anorectal Surgery,People's Hospital of Xinjiang Uygur Autonomous Region,Wulvmuqi 830001,Xinjiang,China)

机构地区：[1]新疆维吾尔自治区人民医院肛肠外科,新疆乌鲁木齐830001

出　　处：《贵州医科大学学报》2021年第8期987-992,共6页Journal of Guizhou Medical University

基　　金：新疆维吾尔自治区自然科学基金(2017D01C306)。

摘　　要：目的探讨地奥司明联合高频电刀肛瘘根治术用于治疗肛瘘的临床疗效。方法选取肛瘘患者120例,随机均分为研究组(采用高频电切肛瘘根治术联合地奥司明治疗)和对照组(采用高频电切肛瘘根治术),观察2组患者手术前、术后第1、3、5及7天创面的水肿状况;采用Wexnei评分法和视觉模拟评分法(VAS)分别评价2组患者术后第7天的排便能力和排便时肛门疼痛指数;运用ZGJ-D型四通道肛肠压力检测仪对2组患者的肛管最大收缩压、肛管最长收缩时间、直肠静息压及肛管静息压;采用VAS评价2组患者术后第3、6及9天的疼痛指数;比较两组患者2周内创面愈合率和治疗效果,比较创面愈合时间和住院时间。结果研究组与对照组患者术后第1、3、5及7天的创面水肿评分均明显低于术前,且研究组患者术后第3、5及7天创面水肿评分明显低于对照组(P<0.001);研究组患者的住院时间、肛门排便能力及排便时肛门疼痛指数均明显低于对照组(P<0.001);2组患者术后直肠静息压和肛管静息压均明显下降,且研究组明显低于对照组(P<0.001);研究组患者术后第3、6及9天时疼痛指数均明显低于对照组(P<0.001);研究组患者的创面愈合时间、术后第7天和第14天创面愈合率分别低于对照组(P<0.001);研究组患者的治疗有效率高于对照组、平均住院时间短于对照组(P<0.01)。结论地奥司明联合高频电刀肛瘘根治术,可通过改善机体静脉循环、淋巴循环和微循环,达到有效治疗肛瘘的目的。Objective To explore the clinical efficacy of diosmin combined with radical resection of anal fistula with high frequency electric knife in the treatment of anal fistula.Methods A total of 120 patients with anal fistula were selected and randomly divided into a study group(resection of anal fistula with high-frequency electric knife combined with diosmin)and a control group(resection of anal fistula with high-frequency electric knife).The edema of wound surface was observed before surgery,on the 1^(st),3^(rd),5^(th)and 7^(th)day after surgery.The defecation ability and anal pain index on the 7 th day after surgery were evaluated by Wexnei score and visual analogue scale(VAS).The ZGJ-D type four-channel anorectal pressure detector was used to measure the maximum systolic pressure of the anal canal,the longest contraction time of the anal canal,the resting pressure of the rectum and the resting pressure of the anal canal.VAS was used to evaluate the pain index of the patients on the 3^(rd),6^(th),and 9^(th)days after surgery.We compared not only the wound healing rate and treatment effect within 2 weeks,but also the wound healing time and hospitalization time between two groups.Results The wound edema scores of the patients on the postoperative days 1,3,5,and 7 were significantly lower than those before surgery.The wound edema scores were significantly lower in study group than those in control group on the 3^(rd),5^(th)and 7^(th) day after surgery(P<0.001).The length of hospital stay,anal defecation ability and anal pain index during defecation were significantly lower in study group than those in the control group(P<0.001).The resting rectal pressure and resting pressure of the anal canal were decreased after surgery,and they were less in study group than in control group(P<0.001).The pain index of patients in study group was significantly lower than that of control group(P<0.001)on the 3 rd,6 th,and 9 th day after surgery(P<0.001).The wound healing time and wound healing rates on the 7 th,and 14 th days after th

关 键 词：直肠瘘 地奥司明 高频电刀根治术 临床疗效 创面愈合度 术后感染 

分 类 号：R605[医药卫生—外科学]