改良切口引流联合挂线术与精准微创术治疗肛瘘对肛门排便功能及并发症的影响  

Effect of modified incision drainage combined with thread-drawing and precise minimally invasive surgery in the treatment of anal fistula on anal defecation function and complications

作　　者：朱秀清 Zhu Xiuqing(Department of Anorectal Medicine,Xin′an International Hospital,Jiaxing 314000,China)

机构地区：[1]浙江新安国际医院肛肠科,嘉兴314000

出　　处：《中国医师进修杂志》2022年第12期1080-1083,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的比较改良切口引流联合挂线术与肛瘘精准微创术治疗肛瘘对肛门排便功能及并发症的影响。方法选取2018年12月至2020年12月在浙江新安国际医院诊治的肛瘘患者105例,按照手术方式的不同将患者分为观察组(58例)和对照组(47例),观察组行改良切口引流联合挂线术,对照组行肛瘘精准微创术,比较两组的治疗效果、排便功能和并发症发生情况。结果两组手术时间、术中出血量、术后首次排便时间、术后正常进食时间比较差异均无统计学意义(P>0.05)。观察组住院时间较对照组延长[(5.29±1.53)d比(4.02±1.16)d],差异有统计学意义(P<0.05)。两组术后肛管静息压、直肠静息压、肛管高压带长度、肛管最大收缩压比较差异均无统计学意义(P>0.05)。两组术后均无肛瘘复发,并且两组术后肛门排便功能优良率、并发症发生率比较差异均无统计学意义(P>0.05)。结论改良切口引流联合挂线术与肛瘘精准微创术治疗肛瘘效果相当,均可有效改善肛门排便功能,且术后安全性较好,无复发情况,但肛瘘精准微创术患者住院时间相对较短。Objective To compare the effects of modified incision drainage combined with thread-drawing and precise minimally invasive surgery in the treatment of anal fistula on anal defecation function and complications.Methods A total of 105 patients with anal fistula who were diagnosed and treated in Xin′an International Hospital from December 2018 to December 2020 were collected.The patients were divided into the observation group(58 cases)and the control group(47 cases)according to surgical methods.The observation group received modified incision drainage combined with thread-drawing surgery.The control group received precise minimally invasive anal fistula surgery.The treatment outcome,anal defecation function and complications were compared between the two groups.Results The operation time,intraoperative blood loss,first defecation time after operation,normal eating time after operation in the two groups had no significant differences(P>0.05).The hospital stay in the observation group was significantly longer than that in the control group:(5.29±1.53)d vs.(4.02±1.16)d,there was statistical differences(P<0.05).After operation,the resting pressure of the anal canal,resting rectal pressure,length of the tube high pressure belt,the maximum systolic pressure of the anal canal between the two groups had no significant differences(P>0.05).The excellent and good rate of anal defecation function and complication rate between the two groups had no significant differences(P>0.05).Conclusions Modified incision drainage combined with thread-hanging surgery in the treatment of anal fistula is equivalent with precision minimally invasive surgery.Both can effectively improve the anal defecation function.The postoperative safety is good and there is no recurrence.However,the hospital stay of patients with precision minimally invasive surgery for anal fistula is relatively shorter.

关 键 词：瘘 肛门疾病 改良切口引流联合挂线术 肛瘘精准微创术 排便功能 并发症 

分 类 号：R657.16[医药卫生—外科学]