内括约肌切开、外括约肌保留术治疗老年坐骨直肠窝脓肿效果观察  

Observation on the effect of internal sphincterotomy and external sphincter preservation in the treat⁃ment of elderly ischiorectal abscess

作　　者：罗京艺[1] 荆淑娟 徐广志 尚毅[1] LUO Jingyi;JING Shujuan;XU Guangzhi;SHANG Yi(Department of Traditional Chinese Medicine Anorectal,The Second People's Hospital of Liaocheng,Linqing 252601,China)

机构地区：[1]聊城市第二人民医院中医肛肠科,山东临清252601

出　　处：《老年医学研究》2023年第1期9-12,共4页Geriatrics Research

摘　　要：目的探讨内括约肌切开、外括约肌保留术治疗老年坐骨直肠窝脓肿的临床效果。方法选取2018年1月—2022年5月在聊城市第二人民医院中医肛肠科住院治疗的96例老年坐骨直肠窝脓肿患者,按随机数字表法分为观察组和对照组,各48例。观察组采用内括约肌切开、外括约肌保留术治疗,对照组采用切开挂线术治疗。术后6个月比较两组患者治疗后的临床疗效;术后第1、3、7、10天采用视觉模拟评分法(VAS)比较两组患者的创面疼痛程度;比较两组患者创面愈合时间;术后6个月采用大便失禁严重度评分(美国Wexner评分)评估两组患者的肛门功能。结果观察组治愈率为89.6%(43/48),对照组为93.8%(45/48),两组比较差异无统计学意义(P=0.712)。术后第1、3、7天,观察组VAS评分分别为(5.21±1.13)、(4.48±0.95)、(3.02±1.01)分,对照组分别为(6.96±1.50)、(6.00±1.13)、(3.67±1.14)分,观察组均较对照组低(P均<0.001)。观察组创面愈合时间为(25.50±4.10)d,低于对照组的(32.85±4.40)d,两组比较差异有统计学意义(P<0.001)。观察组术后6个月Wexner评分为(2.69±1.08)分,低于对照组的(4.23±1.48)分,两组比较差异有统计学意义(P<0.001)。结论采用内括约肌切开、外括约肌保留术治疗老年坐骨直肠窝脓肿,具有疼痛轻、创面愈合快、保护肛门功能的优点。Objective To investigate the clinical efficacy of internal sphincterotomy and external sphincter preservation in the treatment of elderly ischiorectal abscess.Methods From January 2018 to may 2022,96 elderly patients with ischiorectal abscess admitted to the traditional chinese medicine anorectal department of the Second People's Hospital of Liaocheng,were divided into observation group and control group according to random number table,with 48 cases in each group.The observation group was treated with internal sphincterotomy and external sphincter preservation,while the control group was treated with incision-thread-drawing.Six months after operation,the clinical efficacy of the two groups of patients was compared;Visual analogue scale(VAS)was used to compare the degree of wound pain between the two groups on the 1st,3rd,7th and 10th day after operation;the wound healing time of the two groups was compared;the anal function of the two groups was evaluated by the fecal incontinence severity score(Wexner score)6 months after operation.Results The cure rate was 89.6%(43/48)in the observation group and 93.8%(45/48)in the control group,and there was no significant difference between the two groups(P=0.712).On the 1st,3rd and 7th day after operation,the VAS score of the observation group was 5.21±1.13,4.48±0.95,3.02±1.01,and that of the control group was 6.96±1.50,6.00±1.13,3.67±1.14,respectively.The observation group was lower than the control group(all P<0.001).The wound healing time of the observation group was(25.50±4.10)days,which was lower than that of the control group(32.85±4.40)days.The difference between the two groups was statistically significant(P<0.001).The wexner score of the observation group 6 months after operation was(2.69±1.08)points,lower than that of the control group(4.23±1.48)points,and the difference between the two groups was statistically significant(P<0.001).Conclusion Internal sphincterotomy and external sphincter preservation have the advantages of less pain,fast recovery and go

关 键 词：内括约肌切开、外括约肌保留术 坐骨直肠窝脓肿 肛门功能 老年人 

分 类 号：R657.1[医药卫生—外科学]