瘘管转移切割挂线术治疗单纯性经括约肌型肛瘘的临床疗效观察  

Fistula-in-ano conversion combined with cutting seton for simple transsphincter⁃ic fistula-in-ano

作　　者：陈富军[1] 刘昌萍 李杉[1] 程英杰 昝朝元 李刚[1] 李成书[1] 骆川云[1] 贺平[3] Chen Fujun;Liu Changping;Li Shan;Cheng Yingjie;Zan Chaoyuan;Li Gang;Li Chengshu;Luo Chuanyun;He Ping(Department of Coloproctology,The First People’s Hospital of Longquanyi District,Chengdu 610100,Sichuan,China;Department of Coloproctology,Hospital of Chengdu University of TCM,Chengdu 610075,Sichuan,China;DivisonⅠof Department of Coloproctology,Chengdu Rectal Hospital,Chengdu 610000,Sichuan,China)

机构地区：[1]成都市龙泉驿区第一人民医院肛肠科,四川成都610100 [2]成都中医药大学附属医院肛肠科,四川成都610075 [3]成都肛肠专科医院肛肠一科,四川成都610000

出　　处：《结直肠肛门外科》2022年第1期59-63,共5页Journal of Colorectal & Anal Surgery

基　　金：四川省中医药管理局2020年度中医药科研专项课题(2020LC0025)。

摘　　要：目的分析瘘管转移切割挂线术治疗单纯性经括约肌型肛瘘的临床疗效。方法回顾性分析2020年1月至2020年10月于成都市龙泉驿区第一人民医院住院治疗的60例单纯性经括约肌型肛瘘患者的临床资料,根据手术方式的不同,将其中采用瘘管转移切割挂线术治疗的30例患者作为治疗组,采用肛瘘切开挂线引流术治疗的30例患者作为对照组。比较两组疗效、手术时间、术后住院时间、切口愈合时间、术后24 h疼痛程度(NRS评分),以及术后3个月的肛门功能(Wexner肛门失禁评分)。结果两组总体疗效、痊愈率、总显效率比较差异均无统计学意义(均P>0.05)。治疗组手术时间长于对照组,切口愈合较对照组提前(均P<0.05);两组术后住院时间比较差异无统计学意义(P>0.05)。治疗组术后24 h的NRS疼痛评分低于对照组,术后3个月的Wexner肛门失禁评分低于对照组(均P<0.05)。结论瘘管转移切割挂线术治疗单纯性经括约肌型肛瘘疗效确切,与肛瘘切开挂线引流术相比能缩短切口愈合时间、减轻术后疼痛,对肛门功能的影响更小。Objectives To investigate the clinical effectiveness of fistula-in-ano conversion combined with cutting seton for sim⁃ple transsphincteric fistula-in-ano.Methods This was a retrospective analysis of 60 patients with simple transsphincteric fistulain-ano treated at the First People’s Hospital of Longquanyi District,Chengdu between January and October 2020.Patients were divided into the treatment group(n=30,receiving fistula-in-ano conversion combined with cutting seton)and the control group(n=30,receiving incision,seton,and drainage).The following data were compared between the two groups:effectiveness,operation time,postoperative hospitalization,time to wound healing,pain at 24 hours postoperative using the Numeric Rating Score,and anal function at 3 months postoperative using the Wexner anal incontinence score.Results The two groups were comparable con⁃cerning overall effectiveness,the cured rate,and the overall markedly effective rate(P>0.05).The operation time was significantly longer in the treatment group,while the time to wound healing was significantly shorter in the treatment group(P<0.05).Postoper⁃ative hospitalization was similar between the two groups(P>0.05).Pain score of the Numeric Rating Scale at 24 hours postopera⁃tive and the Wexner anal incontinence score at 3 months postoperative was significantly lower in the treatment group than in the control group(P<0.05).Conclusion Fistula-in-ano conversion combined with cutting seton is an effective procedure for simple transsphincteric fistula-in-ano.Compared with incision,seton,and drainage,it can shorten the time to wound healing,alleviate postoperative pain,and has less impact on anal function.

关 键 词：单纯性经括约肌型肛瘘 瘘管转移切割挂线术 肛瘘切开挂线引流术 

分 类 号：R657.16[医药卫生—外科学]