拖线疗法在老年后位马蹄型肛周脓肿的临床应用  

Clinical application of thread-dragging therapy in the treatment of posterior horseshoe-shaped perianal abscess in elderly patients

作　　者：杨智岗 车鸣桦 陈家友 姚一博 Yang Zhigang;Che Minghua;Chen Jiayou;Yao Yibo(Department of General Surgery,Liqun Hospital,Putuo District,Shanghai,200333,P.R.China;Department of Anorectal Surgery,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,200032,P.R.China)

机构地区：[1]上海市普陀区利群医院普外科,上海200333 [2]上海市中医药大学附属龙华医院肛肠外科,上海200032

出　　处：《老年医学与保健》2022年第3期670-674,共5页Geriatrics & Health Care

基　　金：上海市中西医结合学会科研基金(SQ46)。

摘　　要：目的根据老年后位马蹄型肛周脓肿的特点,观察拖线疗法联合一次性根治术的有效性、安全性、复发及成瘘率的情况。方法选择2020年1月—2021年3月于上海市普陀区利群医院收治的老年后位马蹄型肛周脓肿患者60例,采取数字表法随机分为观察组(n=30)和对照组(n=30)。观察组采用拖线疗法联合一次性根治术,对照组采用肛周脓肿切开引流术。观察并比较2组的手术疗效:术后疼痛、发热、愈合时间、肛门功能、复发及成瘘率等指标。结果观察组治疗总有效率明显高于对照组(96.67%vs83.33%,P<0.05);观察组在术后1、3、7d疼痛评分和术后1、3d发热评分均明显低于对照组(P<0.05);观察组术后1周和术后6个月的肛门功能Wexner评分均明显低于对照组(P<0.05);观察组住院时间和住院费用均明显少于对照组(P<0.01)。结论拖线疗法联合一次性根治术治疗老年患者后位马蹄型肛周脓肿安全有效,术后复发率及成瘘率低,可减少医疗资源的浪费,具有一定的社会效益及经济效益以及临床应用价值。Objective To explore the efficacy,safety,recurrence and fistula rate of thread-dragging therapy combined with one-time radical operation according to the characteristics of posterior horseshoe-shaped perianal abscess in the elderly patients.Methods 60elderly patients with posterior horseshoe-shaped perianal abscess admitted to Liqun Hospital in Putuo District from January2020to March2021were selected and randomly divided into observation group(n=30)and control group(n=30)by random number table.The observation group was treated with thread-dragging therapy combined with one-time radical operation,and the control group was treated with perianal abscess incision and drainage.The curative effect,postoperative pain,fever,healing time,anal function,recurrence and fistula rate were observed and compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group(96.67%vs83.33%,P<0.05).The pain score at1,3and7days after operation and the fever score at1and3days after operation of the observation group were significantly lower than those of the control group(P<0.05).At1week and6months after operation,the Wexner scores of anal function of the observation group were significantly lower than thoseof the control group(P<0.05).The hospitalization time and expenses of the observation group were significantly less than those of the control group(P<0.01).Conclusion Thread-dragging therapy combined with one-time radical operation is safe and effective in the treatment of posterior horseshoe-shaped perianal abscess in elderly patients,with low postoperative recurrence rate and fistula formation rate.It can reduce the waste of medical resources and has certain social and economic benefits as well as clinical application value.

关 键 词：老年 马蹄型肛周脓肿 拖线疗法 后位 

分 类 号：R657.15[医药卫生—外科学]