置双腔管封闭负压持续引流联合中药加压灌洗治疗高位肛周脓肿的临床研究  

Clinical Study of Double-lumen Tube Closed Negative Pressure Continuous Drainage Combined with Traditional Chinese Medicine Pressurized Lavage in the Treatment of High Perianal Abscess

作　　者：郭其乐 姚向阳 王琛 张丹凤 张华 彭军良 沈冬晓 杨君君 朱宝国 Guo Qile;Yao Xiangyang;Wang Chen;Zhang Danfeng;Zhang Hua;Peng Junliang;Shen Dongxiao;Yang Junjun;Zhu Baoguo(Shanghai Jinshan District Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201501,China)

机构地区：[1]上海市金山区中西医结合医院,上海201501

出　　处：《中国中医急症》2021年第9期1567-1571,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：上海市卫生和计划生育委员会中医药科研课题(2018LP010);金山区卫健系统第六周期医学重点专科(JSZK2019A02)。

摘　　要：目的观察置双腔管封闭负压持续引流联合中药加压灌洗治疗高位肛周脓肿的临床疗效及安全性。方法将76例患者按随机数字表法分为观察组与对照组各38例。观察组行切开引流后置双腔管封闭负压持续引流联合中药加压灌洗治疗,对照组行切开引流后凡士林纱条填塞结合0.9%氯化钠注射液冲洗治疗,观察两组患者近期及远期临床疗效、术后并发症、愈合进程及肛门功能等情况。结果观察组近期总显效率为92.11%,明显高于对照组的65.79%(P <0.05);观察组术后疼痛、发热评分改善优于对照组(P <0.01),脓腔容积缩小程度、创面愈合时间均明显优于对照组(P <0.01),远期形成脓肿、肛瘘等复发率低于对照组(P <0.01)。结论置双腔管封闭负压持续引流联合中药加压灌洗治疗高位肛周脓肿近、远期临床疗效满意,可减轻术后并发症,缩短愈合时间,保护肛门功能。Objective:To observe the clinical efficacy and safety of double-lumen tube closed negative pressure continuous drainage combined with traditional Chinese medicine pressurized lavage in the treatment of high perianal abscess. Methods:A total of 76 patients were randomly divided into observation group(n = 38)and control group(n = 38). The observation group was treated with double-lumen tube closed negative pressure continuous drainage combined with traditional Chinese medicine pressurized lavage after incision and drainage. The control group was treated with vaseline gauze packing combined with 0.9% normal saline irrigation after incision and drainage. The short-term and long-term clinical effects,postoperative complications,healing process and anal function of the two groups were observed. Results:The short-term total effective rate in the observation group was92.11%,which was significantly higher than that in the control group(65.79%)(P < 0.05). The improvement of postoperative pain and fever score in the observation group was better than that in the control group(P < 0.01).The reduction of pus volume and wound healing time in the observation group were significantly better than those in the control group(P < 0.01),and the recurrence rate of long-term abscess and anal fistula was lower than that in the control group(P < 0.01). Conclusion:Double-lumen tube closed negative pressure continuous drainage combined with traditional Chinese medicine pressurized lavage in the treatment of high perianal abscess has a satisfactory short-term and long-term clinical effect,which can reduce postoperative complications,shorten healing time and protect anal function.

关 键 词：高位肛周脓肿 置双腔管 封闭负压持续引流 中药加压灌洗 

分 类 号：R657.15[医药卫生—外科学]