视频辅助肛瘘镜联合内口封闭治疗经括约肌肛瘘的临床疗效研究  

The clinical effect of video-assisted anal fistulascopy combined with internal orifice sealing in the treatment of transsphincter anal fistula

作　　者：张敏[1] 徐征[1] 黄泽林[1] 冷明敏[1] ZHANG Min;XU Zheng;HUANG Ze-lin;LENG Ming-min(Department of Anorectal,Deyang People’s Hospital,Deyang 618000,China)

机构地区：[1]四川省德阳市人民医院肛肠科,四川德阳618000

出　　处：《实用医院临床杂志》2021年第6期211-214,共4页Practical Journal of Clinical Medicine

摘　　要：目的研究视频辅助肛瘘镜联合内口封闭治疗经括约肌肛瘘的临床疗效。方法选取我院2019年1月至2020年9月收治的74例经括约肌肛瘘患者,利用随机数字表法分为对照组与试验组各37例,对照组采用一次性切开挂线术治疗,试验组采取视频辅助肛瘘镜联合内口封闭治疗,对两组治愈率、成瘘率、愈合时间、Wexner评分、不同时间段(术前及术后2、5、10 d)肛门疼痛评分、肛门坠胀及分泌物评分进行对比。结果试验组总有效率100.00%,高于对照组89.19%;成瘘率2.70%低于对照组10.81%,差异均有统计学意义(P<0.05);术后2、5、10 d两组肛门疼痛评分、肛门坠胀及分泌物评分均明显下降,且相同时间段试验组分值低于对照组;术后两组Wexner评分均较本组术前明显下降,且试验组分值低于对照组,试验组愈合时间短于对照组,差异均有统计学意义(P<0.05)。结论视频辅助肛瘘镜联合内口封闭治疗经括约肌肛瘘疗效更佳,患者疼痛程度更轻、肛门功能更好,值得在今后治疗工作中推广使用。Objective To investigate the clinical efficacy of video-assisted anal fistulascopy combined with internal orifice sealing in the treatment of transsphincter anal fistula.Methods A total of 74 patients with transsphincteric anal fistula admitted to our hospital from January 2019 to September 2020 were selected.The patients were divided into a control group and an experimental group by the random number table method,37 in each group.The control group was treated with one-time incision and thread-drawing technique.The experimental group adopted video-assisted anal fistulascopy combined with internal orifice sealing treatment.The cure rate,fistula formation rate,healing time,Wexner score,and anal pain in different time points(before operation,2,5 and 10 days after operation)were compared between the two groups.The score,anal swelling,and secretion score were compared.Results The total effective rate of the experimental group was 100.00%,which was higher than 89.19%of the control group.The fistula rate was 2.70%in the experimental group,which was lower than 10.81%of the control group(P<0.05).The anal pain score,anal swelling,and secretion scores of the two groups were decreased significantly after 2,5,and 10 days of surgery,and the indexes in the experimental group were lower than those in the control group at the same time points.The Wexner scores of the two groups after surgery were significantly lower than those before operation,and the indexes in the experimental group were significantly lower than those of the control group(P<0.05).The healing time of the experimental group was shorter than that of the control group(P<0.05).Conclusion Video-assisted anal fistulascopy combined with internal orifice sealing has a better effect in the treatment of transsphincteric anal fistula,with less pain and better anal function.It is worthy of promotion and use in future treatment.

关 键 词：经括约肌肛瘘 肛瘘镜 内口封闭 一次性切开挂线术 

分 类 号：R322.4[医药卫生—人体解剖和组织胚胎学]