肛瘘切开加外括约肌减张缝合术和传统肛瘘切开术治疗低位单纯性肛瘘的效果比较  

Comparison on effect of anal fistula incision combined with external sphincter tension reduction suture versus traditional anal incision in the treatment of low simple anal fistula

作　　者：吴盟 袁义燕 熊伟 Wu Meng;Yuan Yiyan;Xiong Wei(Department of Anorectal Surgery,Zhengzhou First People’s Hospital,Zhengzhou 450000,China;Department of Electrocardiogram,the Seventh People’s Hospital of Zhengzhou,Zhengzhou 450000,China)

机构地区：[1]郑州市第一人民医院肛肠外科,郑州450000 [2]郑州市第七人民医院心电图室,郑州450000

出　　处：《中国实用医刊》2022年第6期50-53,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较肛瘘切开加外括约肌减张缝合术和传统肛瘘切开术治疗低位单纯性肛瘘的效果。方法抽取2020年10月至2021年5月郑州市第一人民医院收治的低位单纯性肛瘘患者68例,按随机数字表法分为研究组与对照组,每组34例。对照组行传统肛瘘切开术,研究组行肛瘘切开加外括约肌减张缝合术。比较两组临床效果、视觉模拟评分法(VAS)评分、Wexner评分、肛管直肠压及复发率。结果研究组总有效率(100%,34/34)与对照组(94.12%,32/34)比较差异未见统计学意义(P>0.05)。术后12、24、36 h,研究组VAS评分[(2.41±0.27)、(1.52±0.11)、(0.67±0.08)分]均低于对照组[(3.69±0.31)、(2.14±0.19)、(1.02±0.13)分],P均<0.05。术后2个月,研究组Wexner评分低于对照组,肛管静息压、肛管舒张压、肛管收缩压高于对照组(P<0.05)。随访6个月,两组均未见复发患者。结论与传统肛瘘切开术相比,低位单纯性肛瘘采用肛瘘切开加外括约肌减张缝合术治疗可获得更理想的临床效果,术后疼痛度小,并能减轻对肛门功能和肛管直肠压的影响,加快患者恢复,但两种术式均可获得良好预后效果,避免复发。Objective To compare the effect of anal fistula incision combined with external sphincter tension reduction suture versus traditional anal fistula incision in the treatment of low simple anal fistula.Methods Sixty-eight patients with low simple anal fistula treated in Zhengzhou First People’s Hospital from October 2020 to May 2021 were selected,and they were divided into a study group and a control group by random number table method,with 34 cases in each group.The control group underwent traditional anal fistula incision,and the study group underwent anal fistula incision combined with external sphincter tension reduction suture.The clinical effect,visual analogue scale(VAS)score,Wexner score,anorectal pressure and recurrence rate were compared between the two groups.Results There was no significant difference in total effective rate between study group(100%,34/34)and control group(94.12%,32/34),P>0.05.At 12,24 and 36 h after operation,the VAS scores of the study group were 2.41±0.27,1.52±0.11,0.67±0.08,respectively,lower than 3.69±0.31,2.14±0.19,1.02±0.13 of the control group(all P<0.05).Two months after operation,the Wexner score in the study group was lower than that in the control group,and the anal resting pressure,anal diastolic pressure and anal systolic pressure were higher than those in the control group(P<0.05).After 6 months of follow-up,there was no recurrence case in the two groups.Conclusions Compared with the traditional anal fistula incision,anal fistula incision combined with external sphincter tension reduction suture in the treatment of low simple anal fistula can obtain more ideal clinical effects,reduce the postoperative pain,reduce the impact on anal function and anorectal pressure,and accelerate the recovery of patients.However,both methods can obtain good prognosis and avoid recurrence.

关 键 词：肛瘘 传统肛瘘切开术 外括约肌减张缝合术 

分 类 号：R657.16[医药卫生—外科学]